Briefing: Federal Health Care Reform
The Affordable Care Act became law back in March, but it won’t be entirely implemented until 2018. Several new provisions took effect on Jan. 1, 2011.
What changes took effect on Jan. 1 for people with private insurance?
Workers who use health savings accounts and similar systems can no longer use the pre-tax money to pay for over-the-counter drugs or similar items without a doctor’s permission. The law also now requires that insurance companies spend at least 85 percent of premium dollars (or 80 percent for individual and small business plans) on providing health care services.
What about for Medicare recipients?
For seniors who use Medicare, the law has just added some free preventative services and reduced the prescription drug “doughnut hole” by giving them a 50-percent discount when buying covered brand-name prescription drugs. The changes this month also reduce extra payments for Medicare Advantage plans and provide new services to Medicare recipients leaving the hospital.
What changes have been made already?
Among the provisions that went into effect last year were tax credits for small businesses that offer insurance for their employees, new coverage for individuals with pre-existing conditions and the opportunity for young adults up to age 26 to stay on their parents’ insurance plans. Insurance plans were also required to start offering certain preventative care for free, and banned from rescinding coverage based on technicalities when an enrollee became ill. Lifetime limits on insurance coverage were also eliminated.
What’s up next?
In October, states will be able to start using Medicaid money to offer home- and community-based services to disabled individuals.
When will other big changes happen?
In 2012, the law mandates the use of electronic medical records, encourages providers to band together in “accountable care organizations,” and links Medicare payments to health care quality. In 2014, it adds the provisions that have received the most attention — though they’re very similar to the existing Massachusetts system — including an individual requirement to buy insurance and new government subsidies to help pay for coverage.
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