Posts Tagged ‘obama care’

Thursday, July 29th, 2010

Progressive Democrats Attempt to Revive the Public Health Insurance Option

A group of 129 progressive House of Representatives Democrats, seeking to revive the public option, introduced legislation on July 22 to establish a public health insurance plan that would compete with private health insurers. It is highly unlikely that the House will vote on the legislation this year. Republicans and some moderate Democrats remain strongly opposed to the public option, and Democratic leaders have little interest in reigniting the divisive health care reform debate before the November elections.

Supporters of the Public Option Act (H.R. 5808) claim that the legislation would sharply reduce the federal deficit. The non-partisan Congressional Budget Office (CBO) estimates that the bill would reduce the federal deficit by approximately $68 billion from 2014 to 2020.

The public plan would be administered by the Secretary of Health and Human Services and would be offered through the new health insurance exchange beginning in 2014.  The bill would require the public plan to charge premiums that fully cover its costs for benefit payments and administrative expenses. The plan’s provider payment rates would be based on Medicare reimbursement rates. The legislation has been referred to the House Energy and Commerce Committee.

President Obama Signs Unemployment Insurance Extension Bill into Law

President Barack Obama signed H.R. 4213, the Unemployment Compensation Extension Act of 2010, into law on Thursday, July 22, ending months of partisan squabbling over the measure. Moments after the late Senator Robert Byrd’s (D-WV) replacement, Carte P. Goodwin, was sworn into office, the Senate quickly voted to invoke cloture on the legislation, sending it back to the House, which then passed the measure by a vote of 272-152.

The legislation did not include an extension of the COBRA health insurance subsidies and other safety-net programs that had also expired earlier this year. The legislation will provide unemployment insurance for those who have already exhausted their normal six months of benefits through Nov. 30, 2010; it is retroactive to June 2, 2010. The Congressional Budget Office estimates this extension will add $33.9 billion to the federal deficit over 10 years.

House Republicans Criticize New Rules for $27 Billion Electronic Health Records Program

House Ways and Means Health Subcommittee Republicans alleged during a July 20 hearing that eligibility criteria for the new $27 billion federal electronic health records (EHR) program are too lenient. The EHR program will provide additional Medicare and Medicaid payments, beginning in 2011, to health professionals and hospitals that adopt certified EHRs. The additional payments, which were enacted in 2009 as part of the American Recovery and Reinvestment Act, will likely encourage many physicians and hospitals to purchase and implement EHR systems.

In order to be eligible for additional Medicare and Medicaid payments, hospitals and health care professionals must adopt and make “meaningful use” of certified EHR technology. Dr. David Blumenthal, the National Coordinator for Health Information Technology (IT), testified that the eligibility criteria were designed to accommodate diverse providers, while appropriately encouraging the adoption of EHRs. The Obama Administration had originally proposed more strict eligibility requirements that were denounced by the health care industry as unrealistic.

The new qualification standards are the first in a series of rules, and they apply only to additional payments before 2013. Dr. Blumenthal stated that HHS will place higher demands on providers in the future.

Wednesday, July 21st, 2010

2010
New programs:

  • Temporary retiree reinsurance program.
  • National risk pool, small business tax credit.
  • $250 rebate for Medicare members who reach the “doughnut hole”.

Health Insurance Reforms:

  • No lifetime benefit limits based on dollar amounts.
  • Allowed restricted yearly limits on the dollar value of certain benefits.
  • No coverage rescissions/cancellations (except for fraud or internal misrepresentation).
  • No cost-sharing obligations for preventive services.
  • Must have dependent coverage up to age 26.
  • New internal and external appeal process.
  • No pre-existing condition exclusions for dependent children (under 19 years of age).
  • New health plan disclosure and transparency requirements.

2011
Insurance Reforms:

  • New uniform coverage documents and standard definitions are developed.
  • Must have minimum medical loss ratios.

Medicare Reforms:

  • Start of Medicare Advantage cost-sharing limits.
  • Medicare beneficiaries who reach the doughnut hole to get a 50% discount on brand name drugs.
  • Primary care doctors and general surgeons practicing in underserved areas, such as inner city and rural communities to get a 10% bonus.
  • Medicare Advantage plans begin having payments frozen.

Other:

  • Yearly fee for brand-name drug manufacturers.
  • Start of voluntary long-term care insurance program giving a cash benefit to help those with disabilities stay in their homes or pay nursing home cost: benefit starts 5 years after paying coverage fee.
  • Increased funding for community health centers to provide care for many low-income and uninsured people.

2012

  • Hospitals, doctors and payers encouraged to join forces in “accountable care organizations”.
  • Hospitals with high rates of preventable readmissions facing reduced Medicare payments.

2013

  • Individuals making $200,000 a year or couples making $250,000 would have a higher Medicare payroll tax of 2.35% on earned income – up from the current 1.45%. A new 3.8% tax on unearned income, such as dividends and interest, also added.
  • Contributions to flexible spending accounts (FSAs) limited to $2,500 a year – indexed for inflation. And the threshold for deducting medical expenses on taxes goes from 7.5% to 10% income.
  • Medical device manufacturers have a 2.9% sales tax on medical devices; with exemptions for some, like eyeglasses, contact lens, and hearing aids.
  • No more deduction for expenses allocable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D-eligible retirees.

2014
Coverage Mandates & Subsidies:

  • New Individual and employer coverage responsibilities.
  • New Individual affordability tax credit and expanded small business tax credits.

Health Insurance Exchange & Insurance Reforms:

  • State individual and small group health insurance exchanges operational.
  • Guaranteed issue, guaranteed renewability, modified community rating and minimum benefit standards (“essential benefits” plan) effective.
  • No more lifetime and yearly dollar limits for essential benefits.
  • New taxes on health insurers.

2018

  • New tax (“Cadillac tax”) on employer-sponsored health plans that offer policies with generous coverage levels.

2020

  • Doughnut hole coverage gap in Medicare prescription benefits is fully phased out. Seniors continue to pay the standard 25% of their drug costs until they reach the threshold for Medicare catastrophic coverage.
Friday, July 9th, 2010

Health insurance reform will inevitably add to the already unsustainable federal deficit. In addition, it will prove impossible for the government to create and establish a more efficient system than the one now in place.

These are some of the arguments of more than a dozen states that have filed lawsuits. The lawsuits challenge the constitutionality of the reform. Their arguments also include that the government should not force citizens to buy health insurance.

It will be several years before the reforms take effect, and opponents are trying to ensure that they never will.

But significant improvements have already been made and insurers are also moving into compliance ahead of schedule. New rules forbid insurance companies from denying coverage to children, young adults can now stay on their guardians’ policies until age 26, and setting a lifetime limit on benefits will be banned soon.

Let’s not forget the true objective and that is to reduce costs. The Obama administration  must demonstrate that reforms will eventually bring down costs. This is the true test.

Wednesday, May 19th, 2010

As the comment period ended with respect to medical loss ratio (MLR) regulations, a flurry of letters were sent last week to both the National Association of Insurance Commissioners and the U.S. Department of Health and Human Services. In addition to Aetna health insurance and other insurers, several employer groups have written with comments and concerns, including the American Benefits Council, the National Coalition on Benefits and the National Retail Federation. In all cases, the comments point out that it’s important to assure that positive, quality-oriented elements of health care, such as health information technology, disease management and wellness programs, fraud and abuse regimens, all should count as quality measures when calculating a company’s MLR. The National Retail Federation in particular noted the need for a national MLR for large employer business, a position well embraced by Aetna.

In the never-ending roll-out of proposed health care reform regulations, the Administration last week published yet another set of Interim Final Regulations. This set deals with coverage for dependent children up to age 26 pursuant to the requirement that insurers and group plans allow kids to stay on their parents’ policies or coverage until age 26.  Comments are due by August 11, but the rule is effective July 12, 2010. Many insurers have already announced that they will implement this provision early (e.g., May 31 for Aetna) to cover graduating college students who may have otherwise faced the summer without insurance. Whether self-funded employers follow suit is not as clear. Also, with the temporary fix of Medicare physician reimbursement rates set to run out the end of May, the House is expected to take up a more lasting fix sometime this week. If the House proceeds as expected it will attempt to install a five-year suspension of any physician rate cuts. Aetna supports the change, as it will give this market predictability.

Monday, April 19th, 2010

In Sunday’s edition of the NY Times, buried in the Regional section, comes an analysis of the current health insurance reforms in the state of New York that were implemented over fifteen years ago.  Similar to Obama Care, the state of New York required all health insurance carriers to issue guaranteed acceptance policies to people with pre existing conditions as a means of making the health industry fair and imposes community pricing rather than risk based insurance premiums.  So how did this work for New Yorkers?  About the same way Obama Care critics predict.

According to the New York Times Sunday Edition
“New York’s insurance system has been a working laboratory for the core provision of the new federal health care law — insurance even for those who are already sick and facing huge medical bills — and an expensive lesson in unplanned consequences. Premiums for individual and small group policies have risen so high that state officials and patients’ advocates say that New York’s extensive insurance safety net for people like Ms. Welles is falling apart.

The problem stems in part from the state’s high medical costs and in part from its stringent requirements for insurance companies in the individual and small group market. In 1993, motivated by stories of suffering AIDS patients, the state became one of the first to require insurers to extend individual or small group coverage to anyone with pre-existing illnesses.
New York also became one of the few states that require insurers within each region of the state to charge the same rates for the same benefits, regardless of whether people are old or young, male or female, smokers or nonsmokers, high risk or low risk.

Healthy people, in effect, began to subsidize people who needed more health care. The healthier customers soon discovered that the high premiums were not worth it and dropped out of the plans. The pool of insured people shrank to the point where many of them had high health care needs. Without healthier people to spread the risk, their premiums skyrocketed, a phenomenon known in the trade as the “adverse selection death spiral.”

That death spiral has nearly wiped out the individual health insurance market in the state.  New York has the highest annual premiums for individual policies in the country, at over $6600 for an individual and double for families.

Obama Care supporters argue that the federal individual health insurance mandate will solve this problem. However, the mandate in Massachusetts hasn’t kept costs in line. The New York Times is also skeptical.

“The new federal health care law tries to avoid the death spiral by requiring everyone to have insurance and penalizing those who do not, as well as offering subsidies to low-income customers. But analysts say that provision could prove meaningless if the government does not vigorously enforce the penalties, as insurance companies fear, or if too many people decide it is cheaper to pay the penalty and opt out.

Under the federal law, those who refuse coverage will have to pay an annual penalty of $695 per person, up to $2,085 per family, or 2.5 percent of their household income, whichever is greater. The penalty will be phased in from 2014 to 2016.”

The math is very simple. If an individual has to pay $6600 per year for a policy they feel they don’t really need or pay $2500 on a salary of $100,000, which one will healthy young earners take? Of course this is based on the assumption that the government will actually enforce the mandate, which Democrats insisted the Obama Care bill couldn’t do.

Arguments to this will be that most young  people earn much less and will get federal subsidies, but that still depends on them deciding whether to pay anything for a policy that clearly doesn’t suit them.  The argument has neglected the fact that the actual costs will absolutely skyrocket and that taxpayers will be on the hook for the subsidies, which will have to increase to match the premium hikes to remain effective.  Instead of having premiums based on a rational risk assessment, we have the young and healthy subsidizing premiums for the older and the much less healthy in comparison, who then subsidize the younger and healthier through federal handouts. A crazy way to run health care in the U.S.

The individual health insurance mandate is nothing more than a way to get young people to create a proxy welfare state by forcing them into a extorting health insurance model.  It does nothing to reduce actual costs at all, and in fact makes cost increases both more frequently and more rapidly.

Easy To Insure ME .com would also like to note that this story was buried in the regional section and not the front page.  This reflects on the arrogance of the whole Obama administration and their gag orders on speaking out about health insurance reform.

Friday, April 16th, 2010

As lawmakers returned to Washington this week, Republicans affirmed their commitment to repealing the health care reform legislation, while Democrats continued to campaign on the health care reform law’s merits. Meanwhile, President Obama stepped up his efforts to energize his core supporters by capitalizing on health care reform.

Health Care Reform

New Health Care Reform Law Means Tax Increase for Middle Class: According to a report recently received by congressional staffers, the new health care reform law will result in higher taxes for approximately 14.7 million middle class Americans. Taxpayers can currently deduct medical expenses in excess of 7.5 percent of their adjusted gross income (AGI). Starting in 2013, most taxpayers will only be able to deduct expenses greater than 10 percent of AGI. By limiting the medical expense deduction – a provision widely used by taxpayers who either have a serious illness or are older – the new law is expected to save billions of dollars. However, according to the Joint Committee on Taxation, those taxpayers earning less than $200,000 a year will pay roughly $3.9 billion more in taxes in 2019 alone because of the new limits for this deduction.

Members of Congress Baffled by Health Care Reform Provisions: According to the Congressional Research Service, the new health care reform law may have serious unintended consequences for members of Congress and their employees. Due to ambiguous and confusing language, members of Congress and their staff members may lose access to the Federal Employees Health Benefits Program, effective immediately. Rep. Jason Chaffetz (R-UT) said lawmakers were in the same boat as many Americans, trying to figure out what the new law meant for them. Congressman Chaffetz asked, “If members of Congress cannot explain how it’s going to work for them and their staff, how will they explain it to the rest of America?”

Additional Activities
Massachusetts Court Rejects Bid to Increase Premiums: Last month, insurance executives in Massachusetts attempted to increase their companies’ premiums by as much as 32 percent, citing the expected rise in medical costs associated with insuring individuals and small group customers in Massachusetts. Insurance Commissioner Joseph Murphy rejected the proposals, citing the increases as “excessive.” As a result, representatives from six of the insurance companies sued, claiming the state does not have the authority to cap premiums. On Monday, a Superior Court Judge in Suffolk County ruled against the insurance providers on procedural grounds for not exhausting all administrative remedies within the Department of Insurance before seeking legal intervention.

Unemployment Benefits Extended Again: On Monday, Senate Democrats advanced a measure temporarily extending the unemployment benefits that expired during the recent two-week congressional recess. Democrats achieved cloture (the only formal procedure that Senate rules provide for breaking a filibuster) with 4 key Republican votes in the Senate. The $9.2 billion bill would extend long-term unemployment benefits along with COBRA health care subsidies for unemployed Americans. It would also extend an annual increase in payments to doctors who treat Medicare patients. The unemployment benefits and health care subsidies will continue until May 5, while the other changes will expire on April 30.

The Senate’s action late Monday set the stage for a final vote on the legislation. On Thursday evening, the bill passed 59-38 , and the measure was sent back to the House, which was expected to vote and send it to President Obama for his signature.

Another State Joins Lawsuit Against Health Care Reform Bill: This week, Georgia Governor Sonny Perdue appointed a special assistant attorney general to lead the state’s challenge against the health care reform law. Georgia joins 18 other states in alleging that the new law infringes on Americans’ Constitutional rights by mandating that individuals  purchase health care coverage or pay a penalty. Frank Jones, the state’s pro bono special assistant attorney general, will represent the State of Georgia and join the multiparty lawsuit filed on March 23 in a federal court in Florida. Other states in the suit include Alabama, Arizona, Colorado, Florida, Idaho, Indiana, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington.

Insurance Commissioner Won’t Comply with Law: Also in Georgia, Insurance Commissioner John Oxendine refused a request from the U.S. Department of Health and Human Services to create a pool for high risk insurance plans. His decision to opt out of creating a high risk pool will not affect the cost of insurance for any patients. However, the federal government, instead of the state, will oversee the distribution of certain federal health care funds in Georgia health insurance to ensure that high risk patients receive subsidized premiums on health insurance.

Chairman Waxman Cancels Hearing: House Energy and Commerce Committee Chairman Henry Waxman (D-CA) issued a statement on Wednesday cancelling a hearing called to listen to concerns from major corporations about how they will be impacted by the health care reform bill. Over the past few weeks, several company executives contacted Chairman Waxman and expressed their feelings that the new law may ease their costs if it is implemented properly. Companies like AT&T, Verizon and Caterpillar made news last month when they informed investors they would need to take billions of dollars in write-downs because of changes in how health care subsidies will be taxed.

Public Opinion
Polls this week show that the number of Americans favoring repeal of the health care reform law continues to rise following the law’s enactment. At the same time, President Obama’s job approval ratings have slipped since passage of health care reform.

More Americans Strongly Favor Repeal: In a recent Rasmussen report, 58 percent of Americans – up 4 points from last week – support repealing the new health care reform law. Further, 52 percent of likely voters continue to feel the legislation is bad for the country.

Similar results were found in a new study conducted by Indiana University. Researchers at the Center for Health Policy and Professionalism Research found that 58 percent of Americans are in favor of repealing the health care legislation.

Obama’s Approval Ratings Slip: In a recent AP/Gfk poll, 52 percent of Americans said they disapprove of the way President Obama is handling health care reform, up 6 points since last month. At the same time, 50 percent disapprove of his performance overall, which is up from 46 percent just a month ago.

Looking Ahead
As lawmakers shift their attention to debating financial reform and climate change legislation, President Obama continues to travel the country to discuss with Americans the details of the new health care reform legislation.

Friday, April 16th, 2010

Changes occurring in 2010 include:

Young Adults on Parents’ Health Insurance Plans. Young adults may stay on their parents’ health insurance until age 26, effective six months after enactment.

Prohibition on Pre existing Condition Exclusions for Children. Insurers are prohibited from excluding coverage of any  pre existing condition for children in the individual health insurance market, effective six months after enactment of the bill.

Prohibition Against Plan Rescissions. Carriers providing group or individual coverage are prohibited from rescinding coverage once an enrollee is covered under the plan, except in the case of an individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of the material facts. Effective six months after enactment of the law.

Prohibitions Against Lifetime Maximum Benefit Caps. Carriers providing group or individual coverage are prohibited from setting lifetime maximum limits on the dollar value of benefits and from setting unreasonable annual limits on the dollar value of benefits, effective six months after enactment.

National High Risk Pool. People with pre existing conditions who are uninsurable will be eligible for subsidized coverage through a national high risk pool, beginning 90 days after enactment.

Limits on Share of Private Premiums Insurers Spend on Non Medical Costs. New limits will be set for the percent of premiums that insurers can spend on non medical claim costs.

Annual Review of Health Premium Increases. Effective immediately, the HHS secretary and states will establish a new process for annual review of unreasonable insurance premium increases.

Elimination of Cost Sharing for Preventive Care in Medicare and Private Plans. In 2010, cost sharing for proven preventive care services is eliminated in both Medicare and private plans.

Wednesday, April 14th, 2010

The state House in Tennessee has approved a piece of legislation that will have the state opt out of using tax money from the state to pay for abortions in Tennessee health insurance exchanges. The bill is in response to the federal health care legislation Congress approved and President Barack Obama signed into law last month that includes massive taxpayer funding of abortion.

House members passed HB 2681 on a 70-23 vote and will help protect residents from some abortion funding. The bill strictly limits the use of public funds in health exchanges mandated by the new federal health insurance plan.

The Tennessee health insurance law states that “No health care plan required to be established in this state through an exchange pursuant to federal health care reform legislation enacted by the 111th Congress shall offer coverage for abortion services.”

Friday, April 2nd, 2010

President Obama finalized his health care reform package this week, signing into law the package of fixes approved by the House late last week. While some of the new provisions won’t take effect until 2014, some will be phased in beginning this year.

Health Care Reform
President Obama Signs Final Health Care Bill into Law:  On Tuesday, President Obama signed into law the package of changes to the newly enacted Patient Protection and Affordable Care Act. Approved over unanimous Republican opposition in both chambers of Congress, this reconciliation bill increases the overall cost of the health care reform legislation by $65 billion, bringing the new total to $940 billion over the next 10 years.

What Does This Health Care Reform Legislation Mean: The biggest changes to the nation’s health insurance system will not take effect until 2014. Some of the changes include: the creation of insurance marketplaces called “exchanges” where people can shop for insurance; rules requiring insurers to accept all applicants, including those with pre-existing conditions; and an expansion of state Medicaid programs. Some additional provisions will become effective immediately while others will kick in later this year.

These are some of the features of the new health care overhaul bill passed through the reconciliation process and slated to begin to take effect in 2010:

  • For new sales and subscribers who change policies after March 23, 2010, insurance companies will be required to make additional changes beginning in approximately 6 months, such as removing any member cost sharing for “preventive” benefits (as defined by the legislation). The renewal product requirements beginning for plan years 6 months after enactment include:
  • Coverage for dependents up to age 26;
  • Removal of limits on lifetime maximum benefits;
  • Temporary federal high-risk pools; and
  • Tax credits for small group employers.

Health Care Reform Impacts on Premiums: There are concerns that the new taxes on health insurance will likely increase premiums. Members of the news media report that under the health care overhaul , young adults who buy their own individual health insurance will carry a heavier burden of the medical costs of older Americans. This is expected to raise insurance premiums for young people when the plan takes full effect in 2014.

Additional Activities
Several Companies Push to Repeal Provision of Health Care Law: The American Benefits Council, an association representing hundreds of large corporations, urged President Obama and Congressional Democrats to repeal a provision in the health care bill that reduces the tax deductions allowed to companies that provide drug coverage for their retired employees. As a result of this impending provision, companies like AT&T, Caterpillar, Prudential, Deere Co. and 3M have all announced substantial charges against their first-quarter earnings in order to comply with federal accounting rules.

Insurers Will Comply With Law Regarding Children’s Coverage: This past week, despite vague language in the new health care law regarding coverage of children with pre-existing conditions, insurance companies assured HHS Secretary Kathleen Sebelius that they await clarification and will comply with the law, effective later this year.

Indiana health insurance Joins States’ Lawsuit Against Health Care Bill: In response to the new health care reform legislation, the Attorneys General of several states across the country filed lawsuits arguing against the constitutionality of requiring Americans to purchase health insurance. This week, the state of Indiana joined 13 others in a lawsuit filed last week in a Florida federal court. The 14 states – Indiana, Florida, Alabama, Colorado, Idaho, Louisiana, Michigan, Nebraska, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington – will become joint plaintiffs in the suit and split the costs of the legal challenge.

Doctors Group Files Lawsuit to Repeal Health Care Legislation: The Association of American Physicians and Surgeons filed a lawsuit in the U.S. District Court for the District of Columbia against HHS Secretary Kathleen Sebelius and Social Security Administration Commissioner Michael Astrue. Attorneys for the group argue that the insurance mandate is unconstitutional. They also argued against the constitutionality of other provisions saying, “If the bill goes unchallenged, then it spells the end of freedom in medicine as we know it.”

Public Opinion
More Americans Disapprove of President’s Handling of Health Care: In a recent CNN poll, 54 percent of Americans said they disapprove of the way President Obama is handling health care reform, while 45 percent approve. In addition, 56 percent of respondents feel the Democrats’ health care legislation creates too much government involvement in the nation’s health care system.

Americans Unhappy over Health Care Reform Passage: In a recent USA Today/Gallup poll, 50 percent of Americans said the recent passage of health care reform legislation is a bad thing. Further, 55 percent say health care costs in the U.S. will rise as a result of the bill.

Two Polls Offer Different Results:  In a newly released Rasmussen report, 54 percent of Americans favor repealing the recently enacted health care legislation. Further, 49 percent believe the new law will reduce the quality of care, while 60 percent think it will increase the federal budget deficit. In contrast, supporters of reform are touting the recent CNN poll that shows 50 percent of Americans are either fine with the new legislation or would favor seeing more government involvement in health care. In this poll, only 47 percent of Americans favor repealing the bill.

Looking Ahead
Late this week , President Obama traveled to the swing states of Maine and North Carolina to discuss details of the new health care reform law and its effects on unemployment and small business. At the same time, Republicans continue to debate how best to leverage growing discontent over the bill and its implications in the months leading up to the November elections. In the meantime, it’s within federal agencies such as HHS that much of the detail, timing and how-to questions will be worked out going forward.

Thursday, April 1st, 2010

While the majority of health insurance reform provisions go into effect in 2014, there are a number of provisions that take effect in 2010. Here’s an overview of the provisions that become effective this year:

Immediately at enactment

  • Grandfathering – Plans and individuals that “renew” their coverage are exempt from any provisions of the law. These “grandfathered plans” must comply, however, with the following provisions of the law: extend dependent coverage through age 26, prohibit rescissions, eliminate waiting periods greater than 90 days, and eliminate pre-existing condition exclusions for children
  • Small employer tax credits – provides premium subsidies for small groups with 25 or fewer employees and average salaries of $40K or less

Less than six months

  • High-risk pool program – establish a temporary national high-risk pool for individuals with pre-existing medical conditions. (effective 90 days post enactment through January 1, 2014)
  • Temporary reinsurance for employer retirees – Creates a temporary reinsurance for employers providing health insurance coverage to retirees over 55 who are not eligible for Medicare (effective 90 days post enactment through January 1, 2014)

Six months plus

  • No lifetime limits – Eliminates all lifetime limits on the dollar value of coverage (effective six months post enactment)
  • Restrictions on rescissions – Prohibits insurers from rescinding coverage except in the cases of fraud (effective six months post enactment)
  • No pre-existing conditions for children – Eliminate pre-existing condition exclusions for children under 19 (effective six months post enactment)
  • Dependent age 26 – Extends dependent coverage to age 26 (effective six months post enactment)
  • Preventive care with no cost sharing – Eliminates cost-sharing for certain preventive services (effective January 1, 2011)
  • Appeals process – Individuals  have access to an  internal and external appeals process to appeal decisions by their health insurance plan.