Snap Fact #146

COMING SOON: 

3. Insurance plans offered through Exchanges will cover Essential Health Benefits

Beginning in 2014, health insurance "Exchanges" operating in each state will serve as convenient, internet-accessible marketplaces where individuals, families and small employers can compare private health insurance options and enroll in qualified health plans. Policies sold through the Exchange will be required to include a wide range and level of health care services that have been determined to be "essential health benefits".

4. Reduction in cost and ease of enrollment

Beginning in 2014, individuals and families with incomes between 133% and 400% of the federal poverty level will be eligible to receive federal tax credits for health insurance premiums to make private health insurance much more affordable. In addition, subsidies will be available to reduce a family's cost-sharing expenses (copayments and deductibles) and annual cost-sharing limits. Federal funding is also available to states so that they can upgrade their computer systems to greatly simplify eligibility determinations and enrollment procedures.

5. Basic health plan 

Beginning in 2014, states will have the option of offering a "basic health plan," funded mostly with federal money, to cover individuals whose family income is between 133% to 200% of the federal poverty level. These individuals and families might otherwise find it too expensive to purchase a private insurance policy. The basic health plan is intended to provide more coverage at a lower cost and/or additional benefits than that offered through the Exchange.

Under our current system a shocking number of citizens do not have health insurance. Humanitarian reasons and simple standards of decency aside, the current system is more expensive than having everyone under the umbrella of health insurance coverage. Uninsured people are not turned away at the doors of our hospitals to get sicker or die on the streets. People are cared for and the taxpayer foots the bill. Including all Americans in a comprehensive insurance program would be more humane, more practical, and would save the taxpayer money. Wouldn't it make sense to add Universal Coverage to the reforms you will read about below? Ironically, the very insurance companies who are fighting so hard against the Affordable Health Care Act will find their premium base increase with the additions of the new customers the existing reforms mandate. Imagine the boon it will be when everyone is covered.

ALREADY IN PLACE: 

1. Consumer protections

The Affordable Health Care Act has already required certain reforms to the private insurance market to protect consumers. Here are four areas of reform: 1) Dependents up to the age of 26 may be included on their parents' insurance plans. 2) Most insurance plans can no longer impose annual or lifetime dollar limits on health benefits. 3) Insurers are restricted from rescinding policies once individuals are covered, except in cases of fraud or misrepresentation. 4) Certain preventive health services must be provided without cost-sharing.

2. Insurers can no longer deny coverage due to pre-existing conditions

Children with pre-existing conditions can no longer be excluded from coverage on their family's health insurance policy. Adults with pre-existing health conditions who have been uninsured for at least six months can qualify for a special Pre-existing Condition Insurance Plan (PCIP) available in all states. Beginning in 2014, no insurer will be allowed to deny health insurance to adults based on a pre-existing condition.