Federal Health Care Reform and Your Benefits (June 2010)
By Sandi Burnett
On March 23, 2010, President Obama signed into law the Patient Protection and Affordability Act . This law will result in major changes to the American health care system over the next several years, including Medicare, private insurance, and employer-based, group coverage such as SMC’s CalPERS coverage for full-time faculty and Kaiser coverage for qualifying part-time faculty. Several changes take place right away, while others are phased in through 2020. Here are a few selected provisions which are relevant to us and when they take effect:
2010:
Group health plans are prohibited from placing lifetime caps on coverage.
Insurers are required to permit children to stay on family policies until age 26 (if the young adult is not eligible for employer coverage). For CalPERS, coverage begins after open enrollment – effective January, 2011.
Medicare beneficiaries who hit the “donut hole” in 2010, will receive a $250 rebate check and the “donut hole” will be gradually eliminated by 2020.
Indoor tanning services will have a 10% tax.
The FDA will be allowed to approve generic versions of biologic drugs like insulin, interferon and growth hormone.
New investment in training programs will be provided to increase the number of primary care doctors, nurses, and public health professionals.
2011:
Insurers in the large group market are required to spend at least 85% of premium income on medical services and quality activities for beneficiaries.
Certain people with disabilities will be provided with community-based attendant care.
Chain restaurants and food sold from vending machines will be required to provide nutritional information.
A long-term care insurance program will be created through voluntary pay-roll deductions to provide benefits to adults who become disabled.
The FA will be monitoring these changes and will communicate with you about them as they occur.
