Health care changes we could see in 2010 if House Bill (3962) passes Congress

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While there are many aspects of the Affordable Health Care for America Act (House Bill 3962) that was passed October 29, 2009 by the U.S. House of Representatives, the bill’s measures will be phased in over several years, if passed into law. This article will highlight some of the measures of the bill that would be implemented first, in 2010, if these aspects remain in the final bill passed by the full Congress.

There are various health insurance market reforms, which include the following changes that many Americans have said they support (based on recent polls).

• Ends health insurance rescissions: Health insurance companies will no longer be able to drop coverage and deny payment for care for an existing policy holder if he or she gets sick.
• Prohibits exclusions based on pre-existing conditions beginning in 2013. In 2010, these exclusions will be limited to a look-back of 30 days (instead of the current 6 months). And the period for health plans to exclude coverage of certain conditions is shortened.

 o It also prohibits health plans from limiting or denying coverage for care needed as a result of domestic violence.

• Bans lifetime limits on coverage that insurance companies currently use.
• Increases the dependent age for policies through age 26, if they are not otherwise covered and at their parent’s discretion.
• Extends COBRA coverage until the Health Care Exchange is available. (This is separate from the Recovery Act provisions that provide premium assistance for selected groups.)
• Limits post-retirement reductions of retiree health benefits for those who have already retired, unless the reduction is also made to benefits for active participants.

There are also some improved health care benefits that begin in 2010, including:

• New Long-Term Care program called CLASS ACT which will be a new, voluntary public long-term care insurance program for people with functional limitations. CLASS would be a daily or weekly cash benefit to pay for services and support needed to maintain personal and financial independence. CLASS will supplement, but not replace, traditional sources of Medicaid and/or private long term care insurance.
• Provides immediate help for the uninsured through a $5 billion fund for those who can’t get coverage due to pre-existing conditions.
• Begins to fill the donut hole in Medicare Part D drug coverage, with a 50% discount on brand-name drugs and the donut hole is reduced by $500 in 2010. The donut hole will continue to close during the next several years until it is completely eliminated in 2019.
• Improves preventive health coverage in Medicare and Medicaid by eliminating cost-sharing for preventive care for Medicare recipients and requiring Medicaid to cover services recommended by the Secretary of Health of Human Services (based on evidence of outcomes, such as smoking cessation counseling for pregnant women).
• Mandates 12-months of continuous eligibility in CHIP programs for children in state health insurance plans.

There are other aspects of the bill that could also be implemented in 2010 and beyond, if the house bill is passed by Congress, that are not mentioned here. Learn more about the U.S. House of Representatives health care bill 3962.