u.s. health care reform: what's in? what's out? what's coming?

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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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Page 1: U.S. Health Care Reform: What's In? What's Out? What's Coming?

What’s In, What’s Out &

What’s Coming?

Page 2: U.S. Health Care Reform: What's In? What's Out? What's Coming?

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

Page 3: U.S. Health Care Reform: What's In? What's Out? What's Coming?

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

Page 4: U.S. Health Care Reform: What's In? What's Out? What's Coming?

Health Reform

THE AFFORDABLE CARE ACT SIGNED 23

Page 5: U.S. Health Care Reform: What's In? What's Out? What's Coming?

EFFECTIVE DATES FOR INITIAL ROLLOUT

2010 – 2018

90 67

Total Number of Provisions Number in

Effect

Source: Kaiser Family Foundation

Page 6: U.S. Health Care Reform: What's In? What's Out? What's Coming?

3.5 Million +

What’s in?

COVERAGE FOR ADULT CHILDREN UP TO AGE 26

PRE-EXISTING CONDITIONS INSURANCE PROGRAM (PCIP) CLOSED TO NEW APPLICANTS

Page 7: U.S. Health Care Reform: What's In? What's Out? What's Coming?

FULL COVERAGE FOR CERTAIN PREVENTIVE SERVICES

UNIFORM SUMMARY OF BENEFITS & COVERAGE

Page 8: U.S. Health Care Reform: What's In? What's Out? What's Coming?

3.5 Million +

REMOVED HEALTH SAVINGS PLAN COVERAGE FOR OVER-THE-COUNTER

MEDICATION (UNLESS PRESCRIBED BY A PHYSICIAN)

Page 9: U.S. Health Care Reform: What's In? What's Out? What's Coming?

10% TAX ON TANNING SALONS

SMALL BUSINESS TAX CREDITS

Page 10: U.S. Health Care Reform: What's In? What's Out? What's Coming?

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%

Page 11: U.S. Health Care Reform: What's In? What's Out? What's Coming?

PROHIBITED LIFETIME LIMITS, CANCELLING COVERAGE & PRE-

EXISTING CONDITION EXCLUSION FOR CHILDREN

Page 12: U.S. Health Care Reform: What's In? What's Out? What's Coming?

3.5 Million +

What’s out?

THE CLASS ACT INSURANCE PROGRAM FOR LONG-TERM CARE

SUSPENDED INDEFINITELY

Page 13: U.S. Health Care Reform: What's In? What's Out? What's Coming?

Out for

now

SMALL BUSINESS HEALTH OPTION PROGRAM (SHOP)*

THE BASIC HEALTH PLAN

THE EMPLOYER MANDATE

* Multiple plan option delayed

Page 14: U.S. Health Care Reform: What's In? What's Out? What's Coming?

3.5 Million +

What’s coming?

INDIVIDUAL MANDATE FOR COVERAGE

(2014)

ERASED PRE-EXISTING CONDITIONS EXCLUSIONS (ADULTS-2014)

Page 15: U.S. Health Care Reform: What's In? What's Out? What's Coming?

STATE-BASED INSURANCE EXCHANGES

(2014)

Page 16: U.S. Health Care Reform: What's In? What's Out? What's Coming?

TAX CREDITS/SUBSIDIES TO ELIGIBLE INDIVIDUALS (2014)

NO LIFETIME/ANNUAL LIMITS ON ANY COVERAGE (2014)

Page 17: U.S. Health Care Reform: What's In? What's Out? What's Coming?

3.5 Million + DEFINED CATEGORIES OF ESSENTIAL HEALTH BENEFITS GO INTO EFFECT

(2014 – INDIVIDUAL & SMALL GROUP)

Page 18: U.S. Health Care Reform: What's In? What's Out? What's Coming?

Wellness Programs

ALLOWS EMPLOYERS TO OFFER REWARDS TO EMPLOYEES UP TO 30% OF THE COST OF COVERAGE FOR PARTICIPATION IN PROGRAM (2014)

Page 20: U.S. Health Care Reform: What's In? What's Out? What's Coming?

Cathy Miller, Business Writer

Business site:

www.SimplyStatedBusiness.com