The 2010 Reforms in the House Healthcare Reform Bill

House leadership has released this fact sheet on the key elements of the House healthcare reform bill that will begin in 2010 [pdf].


Among the most important of these front-loaded provision are the creation of the high risk pool, extension of COBRA benefits (which should also include some sort of subsidy program, since COBRA rates are often unaffordable, though select groups do receive assistance under the Recovery Act), upping the age that people can be covered by their parents' plans, and the increased funding for Community Health Centers are all very good starts for 2010. The most key for staunching the bleeding in our system, if you will, are the high risk pool and the Community Health Center funding. More of the uninsured will be able to get insurance through the pool and the CHCs, which are absolutely critical to providing care for the uninsured, will at least see some increased ability to do so.

A handful of the reforms will immediately address issues for Medicare beneficiaries, all solid reforms that should also provide some political help in 2010--seniors vote.

Here's the full list of what will start happening in 2010 under the bill.

  1. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE — Reduces the donut hole by $500 and institutes a 50% discount on brand-name drugs, effective January 1, 2010.
  1. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POOL) — Creates a temporary insurance program until the Exchange is available for individuals who have been uninsured for several months or have been denied a policy because of pre-existing conditions.
  1. BANS LIFETIME LIMITS ON COVERAGE—Prohibits health insurance companies from placing lifetime caps on coverage.  
  1. ENDS RESCISSIONS—Prohibits insurers from nullifying or rescinding a patient’s policy when they file a claim for benefits, except in the case of fraud.
  1. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27TH BIRTHDAY THROUGH PARENTS’ INSURANCE— Requires health plans to allow young people through age 26 to remain on their parents’ insurance policy, at the parents’ choice.  
  1. ELIMINATES COST-SHARING FOR PREVENTIVE SERVICES IN MEDICARE—Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program.  
  1.  IMPROVES HELP FOR LOW-INCOME MEDICARE BENEFICIARIES—Improves the low-income protection programs in Medicare to assure more individuals are able to access this vital help.        
  1. PROVIDES NEW CONSUMER PROTECTIONS IN MEDICARE ADVANTAGE— Prohibits Medicare Advantage plans from charging enrollees higher cost-sharing for services in their private plan than what is charged in traditional Medicare.
  1. IMMEDIATE SUNSHINE ON PRICE GOUGING—Discourages excessive price increases by insurance companies through review and disclosure of insurance rate increases.  
  1. CONTINUITY FOR DISPLACED WORKERS—Allows Americans to keep their COBRA coverage until the Exchange is in place and they can access affordable coverage.        
  1. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.
  1.  HELP FOR EARLY RETIREES—Creates a $10 billon fund to finance a temporary reinsurance program to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64.  
  1.  COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for a doubling of the number of patients seen by the centers over the next 5 years.          
  1. INCREASING NUMBER OF PRIMARY CARE DOCTORS — Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals.

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