On Tuesday, President Barack Obama signed the new health-care bill into law, opening Medicaid to more low-income Americans, requiring uninsured people to buy into government-run insurance exchanges (some plans will be subsidized, according to income), and keeping a tighter leash on insurance companies in terms of both how much money they take in, and whom they cover.
So begins an enormous overhaul of our somehow simultaneously bloated and anemic health-care system, a renovation that’s been hotly debated since Obama took office (and long before that). While many political observers feared reform was dead in January, House Democrats managed to revive the bill and pass it 219-212 (with 34 Democrats defecting, and no Republican support) late on Sunday evening. Both Maine’s Democratic representatives, Mike Michaud and Chellie Pingree, voted for the bill; both of the state’s Republican senators opposed the exact same bill when they voted on it in the Senate. In a compromise designed to secure the votes of anti-abortion Democrats in the House, the president issued a separate executive order reaffirming that federal money may not be used to pay for abortions.
If you’re currently uninsured, you have until 2014 to figure all this out — that’s when everyone is mandated to have health insurance. That year is also when small businesses’ employees will have access to large health-insurance pools to increase their purchasing power, and when government subsidies for coverage will kick in for certain individuals and families.
The bill also has more immediate ramifications. In a conference call on Monday afternoon, Health and Human Services Secretary Kathleen Sebelius outlined the top five near-term changes that will go into effect in October, six months after the bill is signed.
-Young people will be able to stay on their parents’ insurance plans until age 26 (in Maine, this gives them an extra year beyond current state law).
-Insurance companies will no longer be permitted to deny coverage to patients because of pre-existing conditions.
-Small-business owners will immediately be eligible for tax credits (up to 35 percent of employee premiums) if they provide their employees with health insurance.
-Senior citizens will soon see 50-percent discounts on brand-name prescription drugs, and a $250 rebate to make up for “the doughnut hole” — a lack of coverage that occurs when seniors spend between $2700 and $6000 a year on prescription drugs.
-Starting in October, “we’ll begin to look over the shoulder of the insurance” companies, Sebelius says, to monitor what they’re bringing in (premiums) and what they’re paying out (benefits). More than ever before, those numbers will balance out, or so Congress hopes.
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