Health Reform - Let's Talk About It!

Health Care Reform is a much heated topic among most people these days, but what do most Americans really know about Health Reform?  Honestly, even as an insurance agent I was confused myself.  There are resources available for families and business owner's looking to better understand what will be taking place in 2014.  At this point the reform will happen and it is time to educate ourselves on where we are going from here.

It is widely known that employers with over 50 employees are required to provide some form of health coverage to their employees, or the company will be fined for each employee that they have not provided coverage for.  Some larger companies could chose to not provide coverage for their employees and pay the fines which would be cheaper in some cases for them.  In that instance, the employee would be eligible for individual health or the government exchanges depending upon their income. 

Employers with 50 or less employees are not required to provide health to their employees in which case those employees would need to seek coverage from the individual market or the government exchanges based upon their income. 

Taking this one step further smaller businesses or individuals seeking health care have the same two options go to the individual health market if you can afford it and purchase a health plan, or turn to the government exchanges based on your income level. 

To learn more about Health Reform a good reference is Healthreform.kff.org.  Here you can find video's stepping you through the laws, calculators for the government subsidy programs for lower income families, and a timeline of implementation of this reform. 

For those of you currently with HSA Flexible Spending Accounts if you were not already aware please note that as of January 1st 2013 Flexible Spending Account limits were implemented those cost limits are $2,500 per year.  Those costs allowances will increase annually only by the cost of living. 

The Government Exchanges will be open by October of 2013 looking towards 2014 enrollment.  The exchanges for those who do not either have health care via an employer, or who cannot afford individual health will be able to purchase insurance from the exchanges.  The exchanges have varied pricing based on the type of coverage you purchase much like individual health is now.  It is a virtual mall for health care with subsidy programs in place for lower income families. 

How is this Health Reform being paid for??? Well of course this is going to cost money for those who end up in the government exchanges they will be paying for their care based on their income level and of course there will be subsidy availability to those who have lower incomes to help offset the cost.  Some of these costs will be paid for as follows

• Lower medical costs for health providers
• Insurance companies will be paid less in for premiums
• Increased taxes for medicare
• Tanning salon tax implemented goes towards the new reform
• Taxes on medical devices and drugs implemented
• People who do not take health care, or businesses who do not offer health care will be taxed or fined. Those taxes and fines will also go to help pay for the program

It is estimated that the cost of the new government program will be 2% of our national budget go forward and cost 9.3 billion over the next 10 years.  Of course our deficit is in the trillions so closing some spending loop holes to account for the 2% of the national budget will help offset as well. 

What are some of the key requirements the government has told insurer's they can no longer do with their policies? 

• No lifetime limits on your insurance.  Today many people in our country have lifetime insurance maximums on their policies meaning one day they simply run out of insurance coverage for the rest of their lives.  With an aging population of baby boomers this is happening as we speak to many individuals.  This will not occur under the new reform.  There will be no lifetime caps on coverage for health care.
• You cannot be turned down for a pre-existing health condition. 
• You cannot be super charged if you become sick to make your health care unaffordable
• Some services such as well care and vaccinations will be free of charge

There are many more these are just a few changes taking place in the industry some are already implemented.   Keep in mind folks the average family pays an average of $14,000 per year on health care.  Our health care cost have doubled over the last 9 years alone.  With our general population aging the cost without reform would have made health care virtually unaffordable for most.  These changes, though tough to understand, and tough to implement will smooth out health costs overall to make coverage available to most.  The only people not eligible for some form of health care would be illegal immigrants under the law. 

So, where or what are the options for health care then? 

• If you employer offers a health plan and pays a portion you will still be in the same situation you currently are.  If that plan is not affordable you may qualify for the government exchanges.  This is only if the plan offered by your employer is not reasonable or affordable. 
• If you are already responsible for individual health you would obviously still have the option if affordable of purchasing an individual health plan, or seek coverage through the government exchanges based on your income.
• Low income families will be eligible for the exchanges based on affordability and subsidy will be available to offset those out of pocket costs.

Still have questions?  Feel free to email or call our office for up to date education on Health Reform.  Visit Healthreform.kff.org for timeliness, videos, subsidy calculators, state by state implementation overviews, and much more.  Educate yourself today so you can make decisions for your family, your business, your employees that will work for all.  One step closer to making health care affordable for all.

Heather Swank
Owner / Agent
Brookson Insurance LLC
Heather@brooksoninsurance.com
317-534-5202