April 2021
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What Will Health Insurance Plan Reform Do For You Right Now?

Many of the effects of healthcare reform legislation pending in Congress will not be evident for several years. For example, the health insurance plan exchange market and accompanying subsidies for low- and moderate-income individuals are not set to be complete until 2014. Yet, the American public is being asked to begin paying for it today, through various taxes and mandates. Supporters believe that it is a worthwhile investment that will reduce the uninsured population and lead to lower health insurance premiums in the long run, but it is a hard pill to swallow.

However, some provisions will have a more immediate impact. More stringent regulations on insurance companies will take effect as soon as President Obama signs a bill into law. The individual health insurance plan market will become more friendly to consumers as a result. These regulations include a ban on lifetime or annual limits on coverage, bringing peace of mind to those who are unknowingly underinsured: many medical bankruptcies are caused by expensive treatments for cancer or other serious diseases. A lifetime limit of $1 million initially seems generous, but a several-months-long hospital stay and a few rounds of chemotherapy and radiation may soar past that mark. The government will start enforcing this ban six months after the healthcare reform bill passes.

Meanwhile, those with pre-existing conditions are also in luck. Currently, finding a health insurance plan that will cover someone with any chronic diagnosis–even if the condition is manageable with regular medications–is difficult or impossible, unless they have access to insurance through their employer or a family member. Regardless of whether the legislation ends up looking more like the House of Representatives’ version or that of the Senate, finding a suitable plan will be easier. For young adults out of college, many of whom have incomes too low to afford an individual health insurance plan and/or lack full-time employment with insurance benefits, the fact that they will be able to continue their coverage under a parent’s plan for a longer period of time is also reassuring. Depending on which version makes the final cut, they can stay on those plans until they are either 26 or 27 years old.

Another immediately effective limitation on the health insurance industry is related to administrative costs. CEO salaries, shareholder profits, and bloated corporate infrastructure are largely blamed for the increasing cost of a health insurance plan. A provision in the healthcare reform bill would require that insurers spend 80-85% of the premiums they collect on medical care, as opposed to other expenses. It is hoped that such a regulation will either lower health insurance plan premiums or increase the quality of care in the individual health insurance market. Skeptics claim that it will force some insurance companies out of the market, and leave many in the lurch before the regulated exchange markets are up and running.

The uninsured have received a lot of attention in the debate over healthcare reform. While the bulk of the programs meant to provide them with a health insurance plan will take time to set up, both chambers of Congress have taken steps to ensure that they are cared for in the meantime. The House has proposed the creation of a temporary insurance program for those unable to acquire coverage, much like the high-risk insurance pools in many states. Meanwhile, the Senate has allocated $5 billion for another temporary program for the uninsured with pre-existing conditions. Although the former would take effect immediately, the latter would only become effective 90 days after the bill is passed. It is very likely that some form of assistance will survive the final negotiations.

Yamileth Medina PhotoAbout Author
Yamileth Medina is an up and coming expert on Health Insurance and Healthcare Reform. She aims to help people realize that they can find a quality health insurance plan right now. Yamileth lives in Miami, FL.

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