Major provisions of health care reform legislation

WASHINGTON - Here are some of the major provisions of the Patient Protection and Affordable Care Act, which is projected to cost $938 billion over 10 years. The bill passed the House March 21 and was signed into law March 23:

Changes in 2010:

- Insurance companies will be barred from discriminating against children based on pre-existing conditions.

- Parents will be able to keep young-adult children on their health insurance policies up to age 26.

- Senior citizens receiving Medicare will be eligible for free preventive care, such as cancer screenings.

- People receiving Medicare Part D will receive an additional $250 if the cost of their prescription medications reaches the so-called "doughnut hole" coverage gap.

- New health plans must cover preventive care and checkups for free. All plans will be subject to the requirement by 2018.

- Insurance companies will no longer be able to drop a person's coverage when he or she becomes sick.

- Indoor tanning services will be subject to a 10 percent tax beginning July 1.

- A temporary federal program will allow companies to offer health insurance coverage for early retirees between the ages of 55 and 64.

- Employers, including nonprofit groups, with fewer than 25 employees will be eligible for government tax credits to subsidize health insurance for their employees.

- Uninsured Americans with a pre-existing condition will be able to purchase insurance in order to avoid medical bankruptcy.

Changes in 2011:

- Flexible spending accounts will be limited to $2,500 a year and over-the-counter medications not prescribed by a doctor will no longer be eligible for reimbursement.

- Chain restaurants and vending machines will be required to provide nutritional information for each item sold.

- Nonprofit hospitals will be required to perform a community needs assessment and implementation plan every three years and to widely publicize their financial assistance policies.

Changes in 2012:

- Medicare payments will be reduced for preventable hospital readmissions.

- An Independence at Home demonstration project will be created to allow high-need Medicare beneficiaries to receive treatment while remaining in their homes.

- New annual fees will be imposed on the pharmaceutical industry.

Changes in 2013:

- Payroll taxes will increase from 1.45 percent to 2.35 percent for individuals who make more than $200,000 and married couples filing jointly who make more than $250,000.

Changes by 2014:

- All citizens and legal residents will be required to have health insurance coverage or face a tax penalty, with certain exemptions. Individuals and families making up to 400 percent of the federal poverty level ($88,000 for a family of four in 2010) will be eligible for federal tax credits on a sliding scale.

- Medicaid will be expanded to include children, pregnant women, parents and adults under age 65 without dependent children if they earn less than 133 percent of the federal poverty level ($29,326 for a family of four in 2010). The federal government will pay 100 percent of the costs of the newly eligible in 2014 to 2016.

- Insurance companies will be barred from discriminating against adults based on pre-existing conditions, health status or gender.

- All employers will be required to offer health insurance to their employees or face fines. Tax credits to companies and nonprofit groups with 25 or fewer employees and average annual salaries under $50,000 would cover up to 50 percent of the insurance cost.

- Current federal funding levels for the State Children's Health Insurance Program will be extended through 2015.

- New annual fees will be imposed on the health insurance sector.

- State-based insurance "exchanges" will be established that will allow people under certain income levels to buy private health insurance with government tax credits. Only citizens and legal immigrants will be allowed to purchase insurance through the exchanges.

- The Medicare program for senior citizens will move from a fee-for-service reimbursement system for health care providers to a more comprehensive, quality-based system.

- Insurance companies will be prohibited from placing annual or lifetime caps on the dollar value of health coverage.

© Arlington Catholic Herald 2010