A high-level review of health care reform (as of July 2013) from the perspective of employers and individuals purchasing health insurance.

1. What’s In,
What’s Out &
What’s
Coming?

2. Legal stuff
Notice of Disclaimer –Cathy Miller is not an attorney or health care
provider and cannot provide legal or health care advice.
The information provided is for your general background only, and is not
intended to constitute legal or health care advice as to your specific
circumstances.
We recommend you review legislation with legal counsel and visit your
physician for health care issues.
Photo Credits: BigStock Photo

3. NOTE:
The following is a brief overview only (as of July 2013)
and does not include Medicare/Medicaid provisions.
The summary is from the perspective of an individual
who purchases health insurance or an employer that
sponsors health benefits.
U.S. Health Care Reform

4. Health Reform
THE AFFORDABLE
CARE ACT SIGNED
23

5. EFFECTIVE DATES
FOR INITIAL
ROLLOUT
2010 – 2018
90 67
Total
Number of
Provisions Number in
Effect
Source:
Kaiser Family Foundation

6. 3.5
Million +
What’s in?
COVERAGE FOR
ADULT CHILDREN
UP TO AGE 26
PRE-EXISTING CONDITIONS
INSURANCE PROGRAM
(PCIP) CLOSED TO NEW APPLICANTS

7. FULL COVERAGE FOR CERTAIN
PREVENTIVE SERVICES
UNIFORM SUMMARY OF
BENEFITS & COVERAGE

8. 3.5
Million +
REMOVED HEALTH SAVINGS PLAN
COVERAGE FOR OVER-THE-COUNTER
MEDICATION
(UNLESS PRESCRIBED BY A PHYSICIAN)

9. 10% TAX ON
TANNING SALONS
SMALL BUSINESS
TAX CREDITS

10. INCREASED TAX ON NON-
QUALIFIED EXPENSES FOR
HEALTH SAVINGS PLANS
20%
INCREASED ITEMIZED
DEDUCTIONS FOR
MEDICAL EXPENSES
from 7.5% of adjusted gross income
10%

11. PROHIBITED LIFETIME LIMITS,
CANCELLING COVERAGE & PRE-
EXISTING CONDITION EXCLUSION
FOR CHILDREN

12. 3.5
Million +
What’s out?
THE CLASS ACT
INSURANCE PROGRAM
FOR LONG-TERM CARE
SUSPENDED INDEFINITELY

13. Out for
now
SMALL BUSINESS
HEALTH OPTION
PROGRAM (SHOP)*
THE BASIC
HEALTH PLAN
THE EMPLOYER
MANDATE
* Multiple plan option delayed

14. 3.5
Million +
What’s coming?
INDIVIDUAL MANDATE
FOR COVERAGE
(2014)
ERASED PRE-EXISTING
CONDITIONS EXCLUSIONS
(ADULTS-2014)

15. STATE-BASED
INSURANCE EXCHANGES
(2014)

16. TAX CREDITS/SUBSIDIES
TO ELIGIBLE INDIVIDUALS
(2014)
NO LIFETIME/ANNUAL
LIMITS ON ANY
COVERAGE (2014)

17. 3.5
Million +
DEFINED CATEGORIES OF ESSENTIAL
HEALTH BENEFITS GO INTO EFFECT
(2014 – INDIVIDUAL & SMALL GROUP)

18. Wellness Programs
ALLOWS EMPLOYERS TO OFFER
REWARDS TO EMPLOYEES UP TO
30% OF THE COST OF COVERAGE
FOR PARTICIPATION IN PROGRAM
(2014)

19. Cathy Miller, Business Writer
Go to my health care blog
for a 3-part series that explains more about:
Health Care Reform:
What’s In – What’s Out & What’s Coming?
www.SimplyStatedHealthCare.com

20. Cathy Miller, Business Writer
Business site:
www.SimplyStatedBusiness.com