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Healthcare Reform is Here to Stay
By David Straight

David StraightThe election results are in. The Supreme Court has ruled. The Patient Protection and Affordable Care Act, commonly referred to as Obamacare, is here to stay. But what does that really mean?

Some of the changes associated with the healthcare reform law have been implemented, such as insurance requirements that preventive services be covered at no cost and the extension of coverage for dependents to age 26. The biggest and most wide ranging changes will occur in 2014, with preparations taking place in the coming year. Here are just a few highlights:

  • No individual can be denied medical coverage due to pre-existing conditions
  • People who are uninsured will be required to purchase health insurance or pay a penalty tax
  • Individuals will be eligible for government subsidies toward the purchase of health insurance depending upon their household income (Medicaid if below 133% of the Federal Poverty Level, partial subsidy if between 133% and 400% of the Federal Poverty Level)
  • A government-run “exchange” will be formed as a market from which health insurance may be purchased in order to receive government subsidies
  • Employers will be faced with the decision of whether or not to continue offering health coverage as an employee benefit. Large employers will face a fine if they decide to eliminate coverage, but it is small relative to the cost of providing coverage
  • Major taxes will be imposed on medical providers that will have an impact on the delivery of medical services
  • Health insurers will be subject to new rating requirements that will limit the variables by which they can set rates that include age and whether or not enrollees are smokers. Higher premiums are expected.
  • Medicare cuts will occur that may increase the cost and availability of Medicare Advantage Plans going forward.

I’m just scratching the surface of this massive legislation. It’s very confusing and there are many regulations yet to be written under the law. Now more than ever, it will be important to seek counsel from a qualified insurance advisor, like my team at Benefits Network, to help guide you through this “brave new world,” without fear of making a costly mistake.

David Straight is the President and CEO of Benefits Network, Inc., a leading insurance agency and consulting firm specializing in employee benefits, property & casualty insurance, and individual and Medicare products. For more information, call (724) 940-9400 or visit the website at www.benefitsnetwork.biz.

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