USA news

Major health reform legislation enacted

On March 23, 2010, President Barack Obama signed into law the “Patient Protection and Affordable Care Act,” making sweeping changes to the U.S. health care system. The Congress approved this legislation following a highly divisive and partisan debate, with all of the “yes” votes coming from the Democratic party and no support from the Republican party. The legislation expands health insurance coverage, reducing the number of uninsured Americans from 50 million today to an estimated 23 million by 2019. It relies on both private health insurance and a significant expansion of Medicaid government plans for low-income Americans – providing significant opportunities for private health plans managing those populations for the government.

The major provisions of the new law will take effect in 2014. This includes premium subsidies to make coverage more affordable for moderate-income and low-income Americans, combined with a requirement for individuals to purchase coverage (but with weak enforcement) and insurance market reforms that prohibit insurers from discriminating based on a person’s preexisting medical conditions or health status. The law also creates new state-based health insurance exchanges through which individuals and small employers will be offered a range of coverage options meeting minimum standards. Other issues addressed by the new law include new taxes on insurance plans, delivery system reforms, modest steps toward cost containment, administrative simplification, health information technology, prevention and wellness, and the health care workforce.

Several narrowly focused legislative provisions take effect in 2010: a temporary high-risk pool program to cover certain uninsured adults who have pre-existing conditions; new protections for children with pre-existing conditions; tax credits to help certain small employers purchase coverage; the right for young adults to be covered under their parents’ health plan as dependents until they reach age 26; and the elimination of lifetime benefit limits.

A Congressional Research Service (CRS) summary of the bill’s private health insurance provisions can be found at http://www.ahip.org

Source AHIP.