Health Insurance Reform Fast Facts

by Karoli

Consumer Protections

  • No Discrimination for Pre-Existing Conditions
  • No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays
  • No Cost-Sharing for Preventive Care
  • No Dropping of Coverage for Seriously Ill
  • No Gender Discrimination
  • No Annual or Lifetime Caps on Coverage
  • Extended Coverage for Young Adults Under Family Policies
  • Guaranteed Insurance Renewal

Health Insurance Exchange

  • A marketplace for individuals and small businesses to shop for plans best suited to their budgets
  • Exchange-eligible plans include all consumer protections
  • The government will offer a basic plan as an option on the exchange (the “public option”) It must meet the same requirements as insurance company offerings.

Small Business Protections

  • Tax credits for small businesses providing insurance to employees and their families
  • Businesses with up to 10 employees and less than $500,000 in total payroll may choose to allow their employees to purchase individual and family policies through the insurance exchange with no penalty or tax burden.

Affordability

  • Government subsidies for families earning up to 4x the federal poverty level to help with the cost of insurance.
  • Tax credits for small businesses to assist with covering employees.
  • Establishes basic plan requirements: Plans must cover preventive, doctor’s visits, surgical, hospital, Rx, laboratory and clinical. (see consumer protections)

(Note: This is compiled from information available at the time of publication, including bills reported out but not reconciled from the Senate and House)