Patient Protection and Affordable Care Act Provisions Take Effect

September 24, 2010

New provisions of the often dubbed “Obamacare” took effect on the 23rd of September including the highly touted provision that children can remain on their parents insurance policy until their 26th birthday. Though this is thought to be a selling point, most children could already remain on their parents plan as long as they remained enrolled in a school. Under previous plans children who no longer live with their parents or have married are excluded.

This year, health insurance policy’s minimum annual limit is set at $750,000. Next year that minimum annual limit will be adjusted to 1.25 million and 2 million the year after that. In 2014, annual limits will no longer exist. Many experts believe this will force insurance companies to adjust their premiums higher in order to meet the new standards. Another key provision is that minimum annual and lifetime limits no longer exist, the PPAC Act has it’s own fine print which allows for the continuation of annual and lifetime limits on “non-essential” health care services.

In addition, the following provisions have taken effect on or prior to September 23, 2010.

Insurers are prohibited from excluding pre-existing medical conditions (except in grandfathered individual health insurance plans) for children under the age of 19.

Insurers are prohibited from charging co-payments or deductibles for Level A or Level B preventive care and medical screenings on all new insurance plans.

Individuals affected by the Medicare Part D coverage gap will receive a $250 rebate, and 50% of the gap will be eliminated in 2011. The gap will be eliminated by 2020.

Insurers’ abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014.

Insurers are prohibited from dropping policyholders when they get sick.

Insurers are required to reveal details about administrative and executive expenditures.

Insurers are required to implement an appeals process for coverage determination and claims on all new plans.

Enhanced methods of fraud detection are implemented.

Indoor Tanning Tax of 10%

Medicare is expanded to small, rural hospitals and facilities.

Non-profit Blue Cross insurers are required to maintain a loss ratio (money spent on procedures over money incoming) of 85% or higher to take advantage of IRS tax benefits.

Companies which provide early retiree benefits for individuals aged 55–64 are eligible to participate in a temporary program which reduces premium costs.

A new website installed by the Secretary of Health and Human Services will provide consumer insurance information for individuals and small businesses in all states.

A temporary credit program is established to encourage private investment in new therapies for disease treatment and prevention.

While Obamacare continues to be more about confusion than it does about actual health care, Inside Louisiana News will risk our sanity and risk becoming a tax burden in an asylum to try to explain the provisions both pro and con.

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