Obamacare News Blog

How the Health Care Bill Could Affect Your Health Insurance immediately

The U.S. House of Representatives passed the Senate-approved health insurance bill with some provisions to take place immediately and others to take place in 2014. If the reconciliation conditions included in the House bill are approved and it becomes law, the following would provisions would take place.

WITHIN A FEW MONTHS, THE NEW HEALTH CARE BILL PROPOSES:

Lifetime maximums would be removed from health insurance plans.

Typically, health care plans have a listed maximum amount that insurance companies will pay for medical expenses throughout the lifetime of the policy. It varies by plan and state but in California the industry average is $5 million dollars. This currently means if a client has a plan with a $5 million lifetime maximum and has over $5 million in medical cost, he or she is require to pay for any additional fees. Moving forward there would be no lifetime maximum and in the last example the insurance company would be obligated to continue paying beyond the lifetime maximum. To our knowledge, none of our current clients has ever reached their lifetime maximum in reimbursed medical fees. 

Adult Children Covered under Parents policy

The new bill will force health insurance companies to allow children up to the age of 26 to stay on their parents plans. Previously,the age dependents would have to leave their parents plans varied by state and student status. It is unclear if this rule applies to existing plans or only new plans purchased by parents. Also there doesn’t seem to be a provision stopping insurance companies from charging a huge fee to keep older children on the policy.

New “risk pools” set up for those with pre-existing conditions.

Currently many individuals who apply for insurance plan can be turned down for coverage because of pre-existing medical conditions. The bill sets aside $5 billion dollars to help set up a risk pool for people who want coverage but have been turn down due to a medical condition. We are still looking into the details how this pool would work, but we know it will only last until 2014 when the Health Insurance Exchanges (described below) are set up.

Senior Drug Coverage

Although not addressed in most media coverage, the new bill offers some additional drug coverage for those who qualify for Medicare part D. The amount starts off at $250 dollars but goes down in price as drug companies agree to reduce their costs.

IN 2014, THE NEW BILL PROPOSES:

All insurance plans must approve everyone

Guaranteed issuance health insurance is probably the largest change to our existing health care system. It will mean that if you apply for health insurance in 2014 you cannot be turned down due to previous health conditions. It is unclear at this time if the health insurance companies will be able to charge more for people with pre-existing conditions than those who have no previous medical issues.

Health Insurance Exchanges

The proposed health insurance exchange would only be offered in 2014. The exchange would not offer a public option but would be a place where people could research and purchase private health insurance. If you want to see what a health insurance exchange looks like now, just visit www.medicoverage.com. Our site currently acts as a health insurance exchange offering quotes from multiple private insurance companies at the guaranteed lowest price. As you can see, we are unsure what benefit the proposed new health insurance exchanges will offer now that a public option is off the table.

Tax Breaks for Health Insurance Premiums

The recent bill approved by the House will also offer some tax breaks in 2014 if ratified.

Fines for People Without Health Insurance

If you don’t have health insurance in 2014 you will be required to pay a penalty of 1% of your income or $95 (whichever is higher). By 2016 this fee would raise to about $700 or 2.5 percent of your income. This is the health insurance mandate that people talk about. There will be subsidies for certain people who cannot afford health insurance.

Medicare Expansion

The proposed bill will expand medicare to cover more individuals in 2014. Certain people who are living below the poverty line will now quality for Medicare even if they are not 65 years of age.