Extension of Coverage of Adult Children to Age 26
Coverage of Children under 19 with Pre-existing Conditions
• This rule applies whether or not your child’s health problem or disability was discovered or treated before you applied for coverage.
Since this rule was announced, several health plans have decided they will not issue child only policies on the individual market. In that instance, the child could be covered only under a family policy, assuming that the adult applicant is accepted for coverage.
Tax Credits for Small Business
Lifetime and Annual Coverage Limits
Annual limits will not be eliminated until January 1, 2014, but beginning September 23, 2010, employer plans can't impose annual coverage limits of less than $750,000 for "essential" health benefits, including hospital services, drugs, emergency services and maternity and newborn care. This limit will be increased every year prior to 2014, at which time there will be no annual limits permitted.
California’s New High Risk Pool
The premium cost is listed on the application form: for example, an eligible 18 year old person living in San Diego would pay a monthly premium of $181, a 42 year old in San Diego would pay $306/month, and a 60 year old would pay $723/month.
California will receive $761 million in federal funds to operate PCIP through the end of 2013. It is possible that funding will not cover everyone who requests coverage, so submit your application as soon as possible. Interested individuals can apply on-line at http://www.pcip.ca.gov/Publications/PCIP_Supplemental_Application.pdf.
Healthcare reform should be here to stay - The Miami Herald, 9/22/10
Many of these newly vulnerable Americans don't fit the conventional stereotype of people who don't have, and can't get, insurance. They're middle class, and either recently unemployed or simply unable to access the health insurance market for one reason or another. According to the Census Bureau, of the 4.4 million newly uninsured, roughly half have incomes of $50,000 or more.
This is part of the population that the Patient Protection and Affordable Care Act -- ``Obamacare'' -- that Congress passed earlier this year was meant to protect. Unfortunately, the law's mandate that all Americans have health coverage does not go into effect until 2014.
That was a compromise designed to win support for the law. With joblessness lingering and the economy recovering far too slowly, it's a good bet that when the mandate kicks in, the need will be just as great, if not greater, than it is today.
As reported by The Miami Herald's John Dorschner this week, many other features of health reform changes will take effect on Thursday, and not a minute too soon for those with the greatest need.
Among them are the elimination of co-payments for a variety of preventive services and screenings, eliminating lifetime insurance caps, high-risk pools for those who can't get insurance elsewhere and coverage for children up to age 26 through their parents' policies.
Another provision eliminates denial of coverage for children with pre-existing conditions, but already some insurance companies are trying to diminish its impact. Three major insurers -- WellPoint, Cigna and CoventryOne -- have said they would stop offering new child-only insurance plans rather than comply with new rules that require these plans to start accepting children with pre-existing medical conditions after Thursday.
Children who already have child-only policies will not be affected, and kids with pre-existing conditions will be accepted in new family policies. Still, the insurance companies' tactic points to a need for Congress to tweak the law next year.
Indeed, there are many reasons to revisit the package, if only to eliminate confusion and improve guidelines. The requirement that insurance companies spend 85 percent of premiums on healthcare needs better definitions of what constitutes administrative costs, for example.
But tweaking the law and trying to get rid of it altogether, as a lawsuit filed by Florida's attorney general and others aims to do, are two different things. The law is an investment in the health and future of the American people. It can be improved, but it should become a permanent feature of American society.
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