After contentious debate, Congress passed sweeping health care reform legislation in 2010. The controversy still hasn't settled, but meanwhile, what does the law mean for your family? Parent USA City cuts through the clutter.

by Karen M. Doyle

The health care reform bill, officially known as the 2010 Patient Protection and Affordable Care Act, will change the way in which some Americans obtain health care coverage, and will change the coverage offered by insurance companies. But how will it affect families?

Changes in the way you obtain your health insurance

The most important thing to remember about the health care reform bill is that you do not have to change your coverage if you don’t want to. Bottom line:  No one will be forced to change their coverage if they are happy with it.

If you currently receive your health insurance through your employer, you may continue to do so. There are two significant provisions that impact employer-sponsored health insurance. If your company has more than 200 employees, you will automatically be enrolled in your employer’s plan as of 2014. It will be up to you to opt out if you do not want to be covered. Bottom line:  If both spouses work for large companies, be sure you choose the best plan and opt out of the other, so you are not paying for two plans.

The second employer-related provision deals with the oft-discussed “Cadillac plans.” The bill calls for a tax on the most expensive health insurance plans offered by employers. If the plan offered by your employer costs more than $27,500 per year in 2018 (when this provision takes effect), the company, not you, will pay a 40 percent tax on the amount over that threshold. Bottom line:  If you have a top-of-the-line insurance plan, watch for your employer to scale it back prior to 2018.

If you do not have coverage through your employer, or the coverage offered is too expensive, you can purchase your own coverage from a state-sponsored exchange. An exchange is basically a marketplace where insurers compete for your business. If the plan your company offers requires that you pay more then eight percent of your salary for premiums, they have to provide you a voucher equal to the company’s share of the premiums, which you can apply to coverage you purchase at the exchange. If your annual income is less than four times the federal poverty level ($22,050 for a family of four in 2010), government subsidies are available on a sliding scale for policies purchased through an exchange. Bottom line:  If your company’s coverage is too expensive, you can obtain your own coverage, and you may be eligible for help paying for it.

Changes in what—and whom—your plan must cover

By September 2010, insurance plans can no longer deny coverage to children with pre-existing conditions. This provision will be extended to include adults in 2014. This means that if you are uninsured or change insurers, the new plan you choose is required to cover your child regardless of any health condition or disability. Bottom line:  Insurers can no longer deny coverage to children.

Also by September 2010, children can remain on their parents’ health insurance plan until their 27th birthday. Presently, most plans stop covering children when they turn 19, or 23 if the child is a full-time student. This provision applies even if the child is eligible to receive coverage from their employer. Bottom line:  Your children can stay on your health insurance policy until they turn 27 years old.

Health insurance policies will be required to cover preventative care, including well baby check-ups and immunizations, with no cost sharing or co-payment. This provision takes effect in 2010 for new policies purchased individually, and will extend to all health insurance plans by 2018. Bottom line:  Preventative care will be fully covered by all policies by 2018.

The bill includes a requirement for all businesses to provide a suitable area other than a bathroom, and appropriate break time, for nursing mothers to express breast milk. An exemption is offered for those companies with fewer than 50 employees for which compliance would represent an undue hardship. This provision is effective immediately. Bottom line:  Businesses have to provide support for nursing mothers.

There are many more provisions in this comprehensive law, some of which may affect your family. For more information on what is contained in the law and how it will impact parenting children, visit the White House website and click on Health Care Reform: What It Means For You.

 

Karen M. Doyle is a freelance writer who lives with her husband and three children in Scituate, Massachusetts. She writes on parenting topics and personal finance issues, as well as writing what she hopes is humor.