What impact will the PPACA have on individuals who don’t have health insurance?
Beginning in 2014, individuals will be required to maintain minimum health coverage, with the individual mandate provision imposing a penalty that increases over time for failure to maintain such coverage. Certain exceptions are available for those with hardships or religious objections, as well as non-US citizens or incarcerated individuals.
Individuals will have better access to care because insurers who previously denied coverage based on preexisting conditions won’t be permitted to deny coverage. Additionally, subsidies will provide cost relief to eligible individuals and these will come in the form of tax credits and cost-sharing reductions.
What are some of the provisions that go into effect soon?
Both the federal government and the State of Ohio have passed legislation allowing older age children to remain covered under their parents’ health insurance. Effective September 23, 2010, federal law will require health plans to extend eligibility for dependents to age 26. Effective July 1, state law gave insured parties the opportunity to extend coverage to eligible dependents until age 28.
Eligibility requirements for adult children differ between the federal and state laws, but many insurers have extended dependent coverage immediately (rather than waiting for the federal provision to formally take effect) to avoid lapses in coverage. To learn more about the new dependent coverage legislation, talk to your account manager or broker.
The new reform provisions are extensive and many details are being defined to help insurers comply with the new law. We invite individuals to contact their insurance company or broker to gather more information about health care reform.
MARTY HAUSER is the president of SummaCare, Inc., a provider-owned health plan located in Akron, Ohio. SummaCare offers a full line of health plans and ancillary products. Through its extensive network of more than 7,000 providers and more than 50 hospitals, SummaCare offers coverage to more than 115,000 members throughout northern Ohio. Reach him at [email protected].
