How Health Reform Will Affect Consumers in 2010
By now, we all know that the Senate’s health reform bill passed Congress and was signed into law. Barring any unexpected procedural glitches or lawsuits overturning it, its effects will be felt gradually throughout the next decade. While the politics of this health reform has been fascinating to watch, especially for political junkies, the big question now becomes more personal and relevant:
What does this mean for me?
The lion’s share of changes driven by the health reform bill will be effective in 2014, giving us all plenty of time to see it coming, and giving the healthcare industry plenty of time to get ready for it. There are, however, several changes that will take effect immediately and throughout 2010. As an informed healthcare consumer, it is worth knowing what may impact you in the near term. Here is a summary of the 2010 health reform changes that may affect consumers and patients, large and small.
Lifetime maximums for children will no longer apply. This should be a major relief for children with serious medical conditions, where a series of surgeries can test the lifetime limits of insurance policies. The lifting of lifetime maximums for adults will be phased in later this decade.
Employees of smaller companies may start to see new or better health insurance options offered as a benefit. A key provision of the health bill, effective this year, allows for new health care tax credits for employers with less than 25 employees and an average salary of less than $50,000. There will also be a reinsurance pool setup to help for coverage for workers over age 55, meaning that covering older employees may now be made affordable due to the reinsurance pool.
Indoor tanning services will become a little more expensive. A 10% tax will be added to indoor tanning services and likely passed on to customers.
Adult children can stay on parents’ health insurance longer. Children up to age 26 can stay on their parents’ plans. It won’t be free – employers and insurers will need to determine how much premium to associate with adult children – but expect to pay the same as insuring a younger child. In reality, young adults are among the least expensive to cover, so adding them to the risk pool is an important element of making the reform work.
Medicaid recipients will see an immediate increase in various benefits. The Medicaid drug rebate amount will be increased, particularly for brand-name prescription drugs. Coverage will also be expanded to include tobacco cessation services for pregnant women, as well as more home health services for those covered by Medicaid.
Medicare enrollees will receive a $250 credit for the prescription drug donut hole. The donut hole, or coverage gap, is the amount above the $2,700 limit but below the $6,100 catastrophic coverage amount for which seniors are responsible for the entire cost. More changes will be made to the Medicare Part D program in future years, including an eventual phase-out of the coverage gap altogether. These changes cover any drugs in the formulary, both brand name and generic prescriptions.
A new website will be established to allow consumers to compare health insurance. This precursor to a more formal exchange will enable people who shop for individual health plans to better compare health insurance plans. It is unclear who will operate it or what features the site will have, but it is to be operational by July 1.
Medical and nursing students, especially those going into primary care (such as family practice), should begin finding more residency slots. Steps will be taken to increase the number of slots at each school for incoming medical students and nursing, as well as better distribute any current unused slots so more students can take advantage of them. The increased slots are an effort to curb the projected shortage of primary care physicians and nurses in coming years.
While it will take years for most of the effects of health reform to be felt by the typical consumer, the changes effective in 2010 should begin to particularly benefit those on Medicaid, Medicare Part D, or people employed by smaller employers.