We realize that the recent sweeping changes in how health care is paid for in this country by both individual consumers and business can be pretty intimidating. As we always have tried to do with the Vitality Blog, we’re going to attempt to bring you a clear, concise overview of the legislation that passed both houses and was signed into law by the President. We won’t even try to pretend that this is comprehensive in its approach or an immersion into the details of health care reform contained within the Patient Protection and Affordable Care Act (PPACA Pub. L. No. 111-148) as it is more formally known, is a federal statute that was signed into on March 23, 2010 along with the Health Care and Education Reconciliation Act of 2010 (signed into law on March 30, 2010). This new legislation changed the landscape for how we’ll pay for health care in this country.

Here’s a quick recap of the health care reform legislation as we see it:

• The goal of the legislation is to make health insurance in California more affordable and accessible.
• Provide free coverage for certain preventive care screenings and services, the theory being that aggressive preventative measures now will cancel out the need for more expensive health care expenditures that can develop later in life.
• Children can stay on their parents’ California health insurance policies until they are 26.
• Provide financial assistance to those employers who provide California medical insurance to early retirees.
• Remove annual/lifetime limits on coverage.
• Create state-run insurance exchanges beginning in 2014.

MEDICARE

• The basic benefits currently provided in Medicare will not change.
• In 2011, free annual checkups and wellness programs will begin.
• For those in the “donut hole’ as it relates to prescription drug costs:
  • In 2010, a $250 rebate to help cover medication costs.
  • Beginning in 2011, a 50% discount in brand name drugs and biologicals.
  • A complete removal of the medication donut hole by 2020.

PREEXISTING CONDITIONS

• Insurers are not allowed to drop people from CA health plans because of illness.
• Effective July 2010, insurers are not allowed to exclude children from coverage due to preexisting conditions.
• After 2014 adults cannot be denied coverage for California health insurance due to preexisting conditions.

WHAT REFORM MEANS TO CALIFORNIANS

• Individuals are required to have health insurance beginning in 2014 or face fines imposed by the government.
• Effective July, 2010 companies with more than 50 employees must provide health insurance coverage for their workers or pay fines.
• Small businesses will get tax credits if they provide coverage for their employees.

FOR MEDICAID AND INCOME ELIGIBLE

• Families of four earning up to $88,000 will receive tax credits to offset expenses related to the mandatory purchase of California health insurance.
• In 2012, more Californians will be declared eligible for Medicaid or Medi-Cal as it is also known.

Thanks for your review of how Health Care Reform will impact the California health insurance landscape! The Vitality Blog is your reliable online resource for the up-to-date information you need to make informed decisions about the health insurance strategies that are right for you, your family, and your California small business!