Menu
Home

Politics

House of Representatives

What the Health Care Reform Bill Means for You

No more worrying about lifetime limits on health coverage, about whether your insurer will dump you when you get sick, or about whether your adult child will be booted off your plan when he turns 18. 

Kids will be able to stay on their parents' plans until they're 26 if they want and new insurance policies will have to cover certain preventive-care measures with no out-of-pocket cost to the consumer. These are some of the changes that will kick in this year as part of the landmark health-overhaul legislation the U.S. Congress passed on Sunday. 

Insurers also will be barred from denying coverage based on people's pre-existing health conditions for the first time, but children receive this benefit before adults. 

The ban on excluding kids because of illness takes effect six months after passage, but the full adult measure doesn't kick in until 2014. In the meantime, adults with pre-existing conditions who've been uninsured for at least six months can enroll in a temporary high-risk pool and receive subsidized premiums, starting three months after the bill's passage. 

Advocates for consumers and patients hailed the overhaul's passage.  

"While the new reforms won't solve all the problems in our nation's broken health-care system, they will go a long way toward achieving the goal of affordable, reliable health care for all Americans," Jim Guest, chief executive of Consumers Union, said in a statement after the vote. 

What You Can Expect 

Here's an outline of what you can expect depending on your employment, income, health and lifestyle factors. The exact timing of several provisions has yet to be determined. 

-- If you have employer-sponsored coverage: Any lifetime caps on how much your health plan will cover, often set between $1 million and $5 million, will be eliminated in both group and individual health plans starting later this year. Employers will have to disclose the cost of workers' health coverage on their W-2 tax forms starting in 2011. 

-- If you have a small business: Small firms starting this year may be eligible for new tax credits that would cover up to 35% of health-insurance premiums for businesses that have fewer than 25 employees. Workers at small businesses eventually will be able to buy policies on new health-insurance exchanges, where health benefits will have to meet a new minimum standard. 

-- If you're uninsured: Over the next 10 years, the bill will extend coverage to an estimated 32 million people who would otherwise lack coverage. It does this by expanding the government safety net and providing subsidies for low- and moderate-income people without employer health benefits to buy private plans on health-insurance exchanges, which are due to start in 2014. For the first time, all citizens and legal residents will have to buy health insurance--with financial aid from the government if they can't afford it, on a sliding scale up to 400% of the poverty line--or face a penalty starting in 2014, with some exceptions for low-income people. The amounts are set to rise annually, beginning with a fine of $95 or 1% of income, whichever is greater, and growing to as much as $695 or 2.5% of taxable income by 2016. 

Click here to read the full story in The Wall Street Journal.