September to Remember
September was a good month. My brother had a birthday and Health Care reform took another big leap forward. As you may know, the Patient Protection and Affordable Care Act (PPACA) is being rolled out in phases and September 23rd marked another day of roll outs. So what did we get?
For starters young adults can stay on their parents’ health care plan until age 26 instead of being forced to get their own plan. As a graduate student, this is a life saver and it doesn’t matter if I get married or not. Not to mention it can be a cost saver for many American families. What insurance companies soon realized was that it doesn’t cost much to cover a child, but an adult under another adult’s plan throws off their profit scale. By forcing a parent to remove their child from their plan at a certain age the company reduces their payouts and potentially gains more money if the person gets their own individual health insurance. For the business owner this seems like a dream, but for the families affected this is not so good. The US Department of HHS presents statistics showing that young adults have the highest rate of uninsured of any age group, have the lowest rate of access to employer-based insurance, and have chronic illnesses contrary to the belief that they are the healthiest population.
If you think you can’t get on board with this because your plan is not open for insurance, then know that the PPACA has got you covered. For 30 days, starting September 23, 2010, the law allows children who qualify to enroll regardless if the coverage offers an open enrollment period. You know I could see insurance companies changing the benefits and coverage type for these additional qualifiers, but so did the PPACA. In fact the qualified young adult must be offered the same package as other individuals in the same situation. Keep in mind that this doesn’t apply to companies that didn’t have a dependent coverage to begin with.
Now not all insurance companies are bad. In fact a good number of them decided to accept these rules voluntarily BEFORE September 23rd and some may extend the dependent coverage past the 26th birthday. If they do, not only will they be showing some moral responsibility, but they will receive a tax benefit by having the value excluded from the employee’s income. This means that providing this extra coverage will not affect the company’s payroll taxes. This same tax benefit will go to an employee who pays toward their plan as well.
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| PPACA is taking the headache out of Health Care |
Still, these changes are only some of the roll outs. Section 2711 prevents insurance companies from having lifetime and annual limits on the dollar value of benefits. With section 2712 they can’t drop someone once the coverage has begun unless the enrollee has committed fraud and they have to tell you before they drop you. Also, insurance companies can’t deny coverage because of pre-existing medical conditions to children under 19. In addition, patients will have a standardized process of appeals for their claims. First the enrollee will appeal to the internal process and if it is denied they can appeal to an external process and there is a $30 million dollar grant program to back this up. Take a look for yourself by clicking here.
Now, my favorite part of the bill is the portion that enforces coverage of preventive measures. People don’t realize that part of the cost of health care is to treat preventable illnesses. If we can put money into preventing illness, then we won’t pay so much to treat them. The PPACA has made it so you will not have to pay a co-payment, co-insurance or deductible for certain preventive services. These services include, but are not limited to blood pressure tests, diabetes tests, cancer screenings, vaccinations, pregnancy counseling and regular well-baby and well-child visits up until age 21. If you want to see a more detailed list, look here. Now remember, for those “grandfathered” plans this may not apply and you may have to pay for the office visit.
This month, I stayed within my budget for September, Tony and I are one year closer to going to Vegas together, Lamar Odom had a double-double in the world championships and Health Care Reform took another big leap. Yep, September was a good month!
Do you want to know what changes are coming up? Well HealthCare.gov is a great site and they have a nice timeline that tells you what changes are scheduled for when. You can click here to check it out for yourself. You can also check the numerous fact sheets available on HealthCare.gov if you have other questions. These sheets can point you in the right direction, but remember that it is always better to read the bill for yourself. It is H.R. 3590 and can be found on The THOMAS database on the Library of Congress’ Website.
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