By Lisa Zamosky
Now that the Supreme Court has ruled the Affordable Care Act constitutional, this seems like a good time to revisit the law and its impact on your medical care and health insurance coverage.
Here, a review of the parts of the law that are already in effect, as well as what’s to come in the near future.
What’s Law Right Now
- Young adults can stay on their parents’ insurance plans until their 26th birthday
- Through the government’s Pre-Existing Insurance Plans (PCIPs), people with pre-existing health conditions can get insurance if they’ve been without coverage for six months
- Insurance companies can no longer cancel your health plan after you get sick, a practice called rescission. Exceptions include fraud or cases in which a person intentionally withheld information about his orher health status when applying for coverage.
- Children under the age of 19 cannot be denied a health plan
- Maximum lifetime limits on insurers’ benefits have been eliminated
- Small businesses with 25 or fewer employees may be eligible for tax credits up to 35%
- You have the right to appeal your insurance company’s decisions to an impartial third party
- Newer health plans (those created after September 23, 2010) must cover the full cost of preventive medical care (mammograms, colonoscopies, well check-ups) without requiring you to pay co-pays, deductibles, or coinsurance – that goes for those with Medicare too
- Medicare beneficiaries now get a 50% discount on brand-name drugs once they enter the gap in Part D prescription drug coverage known as the “donut hole.”
- This summer, insurers who failed to spend 80% to 85% of your premiums on medical care will have to rebate policyholders the difference (I’ll be writing more about this later in the week).
- In September, insurers will be required for the first time to provide summaries of health plan benefits that make it easier for you to understand what’s included and how one health plan compares with another.
Eighteen months from now, some of the law’s biggest changes are scheduled to take effect:
- People who have pre-existing health conditions cannot be denied insurance coverage or charged more for a health plan because of their illness
- Nearly everyone will be required to have insurance or pay a penalty that amounts to $95 or 1% of your income the first year (whichever is greater). For families, the tax penalty will be $2,085 or 2.5% of household income. Those penalties go up over time.
- Financial help for people making as much as $44,680 a year to pay for health insurance will be available to those who buy a health plan through one of the insurance markets under development now (they won’t be up and running until fall, 2013)
- Medicaid will expand to cover people with incomes below 133% of poverty. However, in its ruling last week, the Supreme Court gave states the flexibility to opt out of this expansion, which could leave low-income people in a real bind. Time will tell how that all works out.
For more details on what this all means, you can read WebMD’s coverage of the Supreme Court’s ruling, including this Q & A in which I respond to reader’s questions about the health reform law and the Supreme Court’s ruling.
And for greater detail about each of the law’s provisions and when they take effect, take a look at Kaiser Family Foundation’s implementation timeline.
Sound off: How are you feeling about the Supreme Court having ruled the law constitutional? Let your feelings be known in the comments section below.