IMMEDIATE BENEFITS OF HEALTH REFORM

En Espanõl

1. SMALL BUSINESS TAX CREDITS

   Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)
   

2. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE

   Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)

3. FREE PREVENTIVE CARE UNDER MEDICARE

   Eliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
   

4. HELP FOR EARLY RETIREES

   Creates a temporary re‐insurance program (until the Exchanges are available) to help offset the costs of expensive premiums for employers and retirees for health benefits for retirees age 55‐64. Effective 90 days after enactment.
   

5. ENDS RESCISSIONS

   Bans insurance companies from dropping people from coverage when they get sick. Effective 6 months after enactment.
   

6. NO DISCRIMINATION AGAINST CHILDREN WITH PRE‐EXISTING CONDITIONS

   Prohibits new health plans in all markets plus grandfathered group health plans from denying coverage to children with pre‐existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)
   

7. BANS LIFETIME LIMITS ON COVERAGE

   Prohibits health insurance companies from placing lifetime caps on coverage. Effective 6 months after enactment.
   

8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE

   Tightly restricts the use of annual limits to ensure access to needed care in all new plans and grandfathered group health plans. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all new plans
   and grandfathered group health plans.)
   

9. FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS

   Requires new private plans to cover preventive services with no co‐payments and with preventive services being exempt from deductibles. Effective 6 months after enactment.
   

10. NEW, INDEPENDENT APPEALS PROCESS

    Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.
    

11. ENSURING VALUE FOR PREMIUM PAYMENTS

    Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.
    

12. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)

    Provides immediate access to affordable insurance for Americans who are uninsured because of a
    pre‐existing condition ‐ through a temporary subsidized high‐risk pool. Effective 90 days after
    enactment.
    

13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS' INSURANCE

    Requires new health plans and certain grandfathered plans to allow young people up to their 26th
    birthday to remain on their parents' insurance policy, at the parents' choice. Effective 6 months after
    enactment.
    

14. COMMUNITY HEALTH CENTERS

    Increases funding for Community Health Centers to allow for nearly a doubling of the number of
    patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.
    

15. INCREASING NUMBER OF PRIMARY CARE DOCTORS

    Provides new investment in training programs to increase the number of primary care doctors,
    nurses, and public health professionals. Effective beginning in fiscal year 2010.
    

16. PROHIBITING DISCRIMINATION BASED ON SALARY

    Prohibits group health plans from establishing any eligibility rules for health care coverage that have
    the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.
    

17. HEALTH INSURANCE CONSUMER INFORMATION

    Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.

18. CREATES NEW, VOLUNTARY, PUBLIC LONG‐TERM CARE INSURANCE PROGRAM

    Creates a long‐term care insurance program to be financed by voluntary payroll deductions to provide home and community-based services to adults who become functionally disabled. Effective on January 1, 2011.