New Health Insurance Markets
Each state is required to have an American Health Benefits Exchange, an online market where people without access to affordable employer coverage can shop for a health plan. Each state will also have a separate exchange for small employers to buy insurance.
Requires Most Businesses to Cover Employees or Pay a Penalty
Businesses with more than 50 full-time employees must offer health insurance to their employees or pay a penalty. The penalty fee will be $2,000 per full-time employee.
New Requirements for Private Insurance
The law requires insurers to comply with new regulations. Starting in 2014, insurers cannot charge people who are older more than three times what a younger person pays. They can only charge one and a half times more for people in various geographic areas or who use tobacco.
Other consumer protections have already been put in place:
- Consumers have the right to appeal an insurer’s decision.
- Preventive care is available to people with private insurance and Medicare with no out-of-pocket costs, including copayments, coinsurance, or deductibles.
- There is guaranteed insurance coverage for children under the age of 19 with pre-existing health conditions. This guarantee will expand to all people with pre-existing conditions in 2014.
- Drug discounts are available for people on Medicare.
- Insurers can no longer impose lifetime limits on health insurance spending.
- Insurers are subject to a review of suspected unreasonable insurance rate increases.
- Insurance companies must spend at least 80% of the money they collect on medical expenses, rather than on marketing or executive salaries.
- Young adults can stay on their parent’s health insurance plan up to the age of 26.
Other Ideas for Health Reform
Give states the power to be in charge of their insurance markets and come up with ways to solve problems such as providing coverage to people who are uninsured or have pre-existing conditions. Ideas include public-private partnerships, exchanges, subsidies, and high-risk pools.
Promote Free Markets
Allow competition to improve the health care system and control costs. This includes:
- Caps on damages in medical malpractice lawsuits
- Allowing individuals and businesses to create pools to buy insurance