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By 2014:
y Insurance companies wont be allowed to deny any person
coverage because of pre-existing conditions, put caps on the amount
they will spend on annual coverage costs, orrefuse to renew a
persons policy because of a persons health condition.
y The law also limits the ability of insurance companies to
charge higher rates because ofhealth status, gender, or other
factors. Higher premiums will be permitted based on age(no more
than three times the amount charged for young people), geography,
family size,and tobacco use.
y States will create health insurance exchanges, which will
provide a way for individualsand small businesses to buy more
affordable coverage. The exchanges will allow peopleto comparison
shop for standardized health packages, and will give tax credits to
helppeople afford coverage.
y Medicaid will expand to cover more low-income people,
including adults withoutchildren and adults without a disability.
The expansion will include people with incomesup to 133% of the
Federal Poverty Level (about $28,000 for a family of 4).
y Most employers will be required to provide coverage, or pay a
fine if they dont(although there will be exceptions for small
businesses with less than 50 employees).This will make
employer-sponsored health coverage more widely available.
y Most individuals will be required to get coverage, or to pay a
fine if they dont. However,there will be healthcare subsidies to
help people buy coverage if their income is below400% of the
Federal Poverty Level (about $88,000 a year for a family of 4). If
affordablecoverage is not available to an individual, they will not
be penalized.
By 2019:
y The donut hole gap in Medicare Part D drug coverage will be
fully phased out,significantly reducing out-of-pocket costs for
people on Medicare.
y Health coverage is expected to have expanded to an additional
32 million people by theend of 2019, and to cover 95% of
non-elderly legal U.S. residents.
Changes Important for People with Disabilities
Some of the changes brought about by these new laws are of
particular significance to peoplewith disabilities:
y By 2014, insurance companies will no longer be able to deny
anyone coverage because ofa pre-existing condition, or to cancel
coverage because of the onset of a new healthcondition. This will
allow people with disabilities more access to private health
coverageplans.
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y The ban on lifetime coverage caps means that insurance
companies cannot stop payingfor treatment once they reach a certain
dollar amount. Costly treatments for ongoingmedical conditions such
as cancer, AIDS, or diabetes will be protected from thesecoverage
caps. This ban goes into effect before the end of 2010.
y Medicaid, which provides health care coverage to low-income
people, will become morewidely available. Since rates of
unemployment and poverty are disproportionately highamong people
with disabilities, it is especially important to people with
disabilities thatMedicaid is accessible. In addition, people with
disabilities will no longer have to gothrough such a complicated
disability determination process to become eligible
forMedicaid.
y The Medicaid Community First Choice (CFC) Option will give
states the option to allowpeople with disabilities who are eligible
for institutional care to choose community-basedservices instead.
This will allow more people with disabilities who are on Medicaid
tostay in their homes, instead of going into an institution. The
CFC Option takes effect on
October 1, 2011.
y Starting in 2012, the Community Living Assistance Services and
Support Act (CLASSAct) provides for voluntary, self-funded,
long-term care insurance through the workplace.This insurance will
help pay for long-term care costs for people with disabilities.
Peoplewith disabilities who participate will be able to start
receiving cash benefits from thisinsurance after five years, and
they will also be able to use their insurance to provide fortheir
long-term care in the future. This program will make long-term
in-home supportservices more affordable, and will help people with
disabilities remain in their homes andcommunities.
Sources:
Patient Protection and Affordable Care Act (Public Law
111-148)Kaiser Family FoundationThe New York TimesSpeaker of the
HouseMcClatchy NewspapersThe National Council on Independent
LivingCongressional Budget OfficeHouse Committees on Ways and
Means, Energy and Commerce, and Education and Labor
