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Key Provisions of Health Reform within the First Year 

·         Tax Credits for certain small businesses (including tax-exempt small businesses) that provide coverage to employees

·         Lifetime limits on benefits will be eliminated, and insurers will be prohibited from canceling coverage retroactively except in the case of fraud

·         High Risk Pools where individuals lacking health insurance and having pre-existing conditions can enroll to get health insurance coverage.

·         Dependent Coverage that allows children to remain on their parent’s plans until age 26 and restricts insurers from denying coverage for a child’s pre-existing condition

·         For Medicare recipients, discounts and rebates will be provided for those who hit the so-called “doughnut hole” in prescription benefits, and the availability of no-cost preventive care, such as some types of cancer screening

·         Temporary Reinsurance Program to help employers provide coverage to retirees over 55 that are not eligible for Medicare

·         Those with HRA’s, HSA’s or Health FSAs will need a prescription for any over-the-counter drugs they seek reimbursement for from these accounts

 

 

Key Provisions of Health Reform in Subsequent Years 

·         Require that insurers take all applicants

·         Mandate that everyone have insurance (with certain exceptions) or otherwise be subject to a penalty

·         Assess a fee on certain employers (over 50 full-time employees) who do not provide health insurance coverage for employees, or require that employers provide Free Choice Vouchers to certain employees

·         Establish State-based Exchanges through which individuals and small businesses with up to 100 employees can purchase qualified health insurance (may be open to larger businesses in the future)

·         Provide premium tax credits, or subsidies to certain income-eligible individuals to be used towards the purchase of health insurance in the new Exchanges

·         Prohibit insurers from denying coverage for pre-existing conditions in adults

·         Increased taxes on high-income earners and “Cadillac Plans” to help finance health reform