How Will Health Care Reform Affect YOU?

health care reformThe brouhaha over health care reform is mostly over, and the only question now is how it affects you. The changes won't take place overnight, and there's a chance that not much will change for you at all, if you have good insurance through your employer. Some new programs (like a high-risk pool for people who can’t buy insurance because of pre-existing conditions) will start to be implemented over the next year. Other changes won’t take affect for three or four years.

Here’s what you need to know:

Young People Will Be Allowed To Stay On Parents' Insurance Plans Until Age 26.

This will take place within six months, and is great news for recent grads who can’t find a job or who are stuck in jobs that don’t offer health coverage.

Healthy People Under 30 Can Buy A Low-Cost Plan.

If you’re under 30, uninsured, but pretty darn healthy, you can buy a catastrophic plan, which will help you avoid financial ruin if you run up against a real health emergency. These plans will cover three primary care doctor visits a year, so you can still get an annual check up. The bad news? This is one of the provisions that doesn’t kick in until 2014.

Insurers Can’t Say No.

Starting in 2014, insurers can’t refuse to provide insurance because you have a pre-existing condition. In the meantime, they can’t cut your insurance off after you get sick, so you don’t have to worry about being left in the lurch if you come down with a chronic disease or a condition that's expensive to treat. Later this year, a high-risk pool is expected to be set up to provide interim coverage. The caps on out-of-pocket costs will be a little less than $6,000 for singles and $12,000 for families. So, complicated health issues will still cost you, but they shouldn't bring you to complete financial ruin.

You Can’t Say No, Either.

By 2014, you'll probably have to buy insurance or pay a penalty, with some exceptions for those with very low income. There will be subsidies if you’re footing the bill for your own health care, but they phase out at 400% of the poverty level. Right now, that’s a little more than $43,000 for single people and just over $58,000 for couple.

It'll Be Easier To Comparison Shop For Insurance Plans.

In a move that’s been compared to setting up a Consumer Reports for health care, states will set up health insurance exchanges. In theory, insurers will have to explain their policies in a uniform way, and in simple language, so that consumers can make an easy, apples-to-apples comparison. This should help people choose the policy that offers the best value for its price.

Your Insurance Dollars Should Go Further.

The reform bill states that 80% to 85% of your insurance premium has to be spent on your medical care, so insurers can’t fund their own inefficiencies from your money or fatten their profits by cutting back on care. The upshot could be less gate-keeping and restrictions on costs of treatments or visits to specialists.

Companies With More Than 50 Employees Will Provide Insurance.

Or, they'll face penalties. If your employer’s plan is too expensive (you’re spending more than 9.5% of your income for access) or doesn’t cover enough (at least 60% of your health care costs), you might be able to have your company pay for all or most of a plan you bought on the exchanges, via a voucher plan.

One Negative: Flexible Spending Accounts Will Shrink.

In 2013, you won’t be able to put more than $2,500 in a flexible spending account—a perk employers offer so you can set aside pretax dollars for health care costs. Most plans top out at almost twice the level now. All the same, if you used to put a lot of money in a flexible spending account because you had a high deductible insurance plan, you might be one of those people who will be allowed to shop around—and you might be better off.


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