The Richmond Register

June 30, 2012

Changes in services, funding


Key features of the Affordable Care Act already enacted:
• Prohibiting denying coverage of children based on pre-existing conditions
• Prohibiting insurance companies from rescinding coverage
• Eliminating life limits on insurance coverage
• Establishing an external review process for appealing insurance company decisions
• Providing free preventative care (no co-pays, deductibles or coinsurance) under health insurance plans for a variety of services:
Adults: Depression, Type 2 diabetes, colorectal cancer and HIV screenings, plus immunizations
Women, pregnant women: Anemia, gestational diabetes and Rh incompatibility screenings, plus breastfeeding support and supplies, and domestic violence screening and counseling
Children: Autism, hearing, obesity, vision, oral health and lead screenings, plus vaccines from birth to age 18
• Creating the Pre-Existing Condition Insurance Plan (PCIP) for people who cannot get insurance because of pre-existing conditions. States may run the program, but if they do not, there is a federal program.
• Extending coverage for young adults, up to the age of 26, by allowing them to stay on their parents’ plan
• Requiring health insurance companies to spend at least 85 percent of all premium dollars collected on health care services. If this goal is not met, rebates must be provided to customers.
Upcoming changes
• Prohibiting discrimination because of pre-existing conditions or gender
• Eliminating annual limits on insurance coverage
• Making care more affordable by providing advanceable tax credits to people with income between 100 to 400 percent of the poverty line who are not eligible for other affordable coverage.
• Establishing affordable insurance exchanges for people whose employer does not offer health insurance.
• Increasing access to Medicaid by expanding the program to include people who earn less than 133 percent of the poverty level ($14,000 for an individual and $29,000 for a family of four). States will get 100 percent of funding for the first three years of the expansion from the federal government, then 90 percent.