U.S. Health Care Reform: What's In? What's Out? What's Coming?

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A high-level review of health care reform (as of July 2013) from the perspective of employers and individuals purchasing health insurance.

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U.S. Health Care Reform: What's In? What's Out? What's Coming?

  1. 1. What’s In, What’s Out & What’s Coming?
  2. 2. Legal stuff Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues. Photo Credits: BigStock Photo
  3. 3. NOTE: The following is a brief overview only (as of July 2013) and does not include Medicare/Medicaid provisions. The summary is from the perspective of an individual who purchases health insurance or an employer that sponsors health benefits. U.S. Health Care Reform
  4. 4. Health Reform THE AFFORDABLE CARE ACT SIGNED 23
  5. 5. EFFECTIVE DATES FOR INITIAL ROLLOUT 2010 – 2018 90 67 Total Number of Provisions Number in Effect Source: Kaiser Family Foundation
  6. 6. 3.5 Million + What’s in? COVERAGE FOR ADULT CHILDREN UP TO AGE 26 PRE-EXISTING CONDITIONS INSURANCE PROGRAM (PCIP) CLOSED TO NEW APPLICANTS
  7. 7. FULL COVERAGE FOR CERTAIN PREVENTIVE SERVICES UNIFORM SUMMARY OF BENEFITS & COVERAGE
  8. 8. 3.5 Million + REMOVED HEALTH SAVINGS PLAN COVERAGE FOR OVER-THE-COUNTER MEDICATION (UNLESS PRESCRIBED BY A PHYSICIAN)
  9. 9. 10% TAX ON TANNING SALONS SMALL BUSINESS TAX CREDITS
  10. 10. INCREASED TAX ON NON- QUALIFIED EXPENSES FOR HEALTH SAVINGS PLANS 20% INCREASED ITEMIZED DEDUCTIONS FOR MEDICAL EXPENSES from 7.5% of adjusted gross income 10%
  11. 11. PROHIBITED LIFETIME LIMITS, CANCELLING COVERAGE & PRE- EXISTING CONDITION EXCLUSION FOR CHILDREN
  12. 12. 3.5 Million + What’s out? THE CLASS ACT INSURANCE PROGRAM FOR LONG-TERM CARE SUSPENDED INDEFINITELY
  13. 13. Out for now SMALL BUSINESS HEALTH OPTION PROGRAM (SHOP)* THE BASIC HEALTH PLAN THE EMPLOYER MANDATE * Multiple plan option delayed
  14. 14. 3.5 Million + What’s coming? INDIVIDUAL MANDATE FOR COVERAGE (2014) ERASED PRE-EXISTING CONDITIONS EXCLUSIONS (ADULTS-2014)
  15. 15. STATE-BASED INSURANCE EXCHANGES (2014)
  16. 16. TAX CREDITS/SUBSIDIES TO ELIGIBLE INDIVIDUALS (2014) NO LIFETIME/ANNUAL LIMITS ON ANY COVERAGE (2014)
  17. 17. 3.5 Million + DEFINED CATEGORIES OF ESSENTIAL HEALTH BENEFITS GO INTO EFFECT (2014 – INDIVIDUAL & SMALL GROUP)
  18. 18. Wellness Programs ALLOWS EMPLOYERS TO OFFER REWARDS TO EMPLOYEES UP TO 30% OF THE COST OF COVERAGE FOR PARTICIPATION IN PROGRAM (2014)
  19. 19. Cathy Miller, Business Writer Go to my health care blog for a 3-part series that explains more about: Health Care Reform: What’s In – What’s Out & What’s Coming? www.SimplyStatedHealthCare.com
  20. 20. Cathy Miller, Business Writer Business site: www.SimplyStatedBusiness.com

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