From what I've read, health care reform provisions won't take effect until 2013, when I will be 65 and qualify for Medicare. What do we do for health insurance in the next three to five years? Cross our fingers and hope that we have no medical issues during that time?
-- Connie B., Salt Lake City
Because of the recession, Connie's husband, a real estate agent, dropped his expensive individual health plan. Now insurance companies are saying both have pre-existing conditions and won't offer them coverage. Congressional Democrats have repeatedly cited examples similar to this one when touting their plan. But Connie is skeptical. She worries the bill offers them no relief in the short term and once enacted only will add to their hardships. She doesn't expect to qualify for any federal help paying for premiums and worries that she faces a fine if she doesn't get insurance.
While Connie is right that most of the major provisions won't kick in for a few years, all the health reform proposals include some immediate reforms, such as the creation of a new high-risk insurance pool. The pool would serve the uninsured and people such as Connie who were denied because of a pre-existing condition.
The House set aside $5 billion to create the program.
The Health and Human Services secretary would determine what was covered, though deductibles would be capped at $1,500 for an individual and the ceiling for out-of-pocket costs in a year would be set at $5,000. This new high-risk coverage would phase out once online insurance marketplaces are set up, which is expected to take place in 2013.
The legislation also extends COBRA benefits and reduces insurance companies' ability to restrict coverage for pre-existing conditions, while the online marketplaces, known as exchanges, are being developed.
Any requirement to have insurance or federal help paying for it won't take place until 2013. The government subsidies, in all of the major bills, are based on a sliding scale and cap out at 400 percent of the federal poverty level. For a family of four that equates to $88,200.
Source » House bill and the Kaiser Family Foundation
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