what patients should know
DESCRIPTION
About Healthcare ReformTRANSCRIPT
-
Pro
vis
ion
D
ate
of
En
act
me
nt
Su
mm
ary
A
cce
ss t
o In
sura
nce
fo
r U
nin
sure
d w
ith
a
Pre
-Exi
stin
g C
on
dit
ion
s
90
da
ys a
fte
r e
na
ctm
en
t P
rov
ide
s u
nin
sure
d A
me
rica
ns
wit
h p
re-e
xist
ing
co
nd
itio
ns
acc
ess
to
co
ve
rag
e. T
he
te
mp
ora
ry h
igh
-ris
k p
oo
l will
serv
e a
s a
bri
dg
e t
o w
he
n t
he
ne
w h
ea
lth
insu
ran
ce E
xch
an
ge
s a
re u
p a
nd
ru
nn
ing
, at
wh
ich
po
int
insu
ran
ce
com
pa
nie
s w
ill n
o lo
ng
er
be
ab
le t
o d
en
y co
ve
rag
e b
ase
d o
n p
re-e
xist
ing
co
nd
itio
ns.
Sm
all
Bu
sin
ess
He
alt
h In
sura
nce
Cre
dit
Ta
xab
le y
ea
r 2
01
0
Pro
vid
es
a t
ax
cre
dit
fo
r q
ua
lifie
d s
ma
ll b
usi
ne
sse
s to
he
lp t
he
m a
ffo
rd in
sura
nce
co
ve
rag
e f
or
the
ir w
ork
ers
. Th
e
cre
dit
is u
p t
o 3
5 p
erc
en
t o
f th
e e
mp
loye
rs
con
trib
uti
on
to
th
e e
mp
loye
es
he
alt
h in
sura
nce
. Th
ere
is a
lso
up
to
a 2
5
pe
rce
nt
cre
dit
fo
r sm
all
no
np
rofi
t o
rga
niz
ati
on
s. I
n 2
01
4, t
ax
cre
dit
s w
ill b
e u
p t
o 5
0 p
erc
en
t o
f p
rem
ium
s fo
r sm
all
bu
sin
ess
es
an
d u
p t
o 3
5 p
erc
en
t fo
r n
on
-pro
fits
wh
o p
art
icip
ate
in t
he
he
alt
h in
sura
nce
exc
ha
ng
e.
No
Dis
crim
ina
tio
n A
ga
inst
Ch
ildre
n w
ith
Pre
-Exi
stin
g C
on
dit
ion
s
6 m
on
ths
aft
er
en
act
me
nt
Pro
hib
its
ne
w h
ea
lth
pla
ns
in a
ll m
ark
ets
an
d g
ran
dfa
the
red
gro
up
he
alt
h p
lan
s fr
om
de
nyi
ng
acc
ess
to
an
d c
ov
era
ge
of
child
ren
wit
h p
ree
xist
ing
co
nd
itio
ns
up
to
ag
e 1
9.
Me
dic
are
Pa
rt D
D
on
ut
Ho
le
20
10
P
rov
ide
s a
$2
50
re
ba
te c
he
ck f
or
Me
dic
are
Pa
rt D
en
rolle
es
wh
o h
it t
he
ga
p in
pre
scri
pti
on
dru
g c
ov
era
ge
kn
ow
n a
s
the
do
nu
t h
ole
. C
urr
en
tly,
th
e c
ov
era
ge
ga
p f
alls
be
twe
en
$2
,83
0 a
nd
$6
,44
0 in
to
tal d
rug
sp
en
din
g.
Be
gin
nin
g in
20
11
, se
nio
rs w
ho
re
ach
th
e d
on
ut
ho
le w
ill g
et
a 5
0 p
erc
en
t d
isco
un
t o
n b
ran
d-n
am
e d
rug
s a
nd
gra
du
ally
incr
ea
sin
g
dis
cou
nts
on
ge
ne
ric
dru
gs.
Th
e d
on
ut
ho
le w
ill b
e c
lose
d c
om
ple
tely
by
20
20
.
Pro
hib
its
Dro
pp
ing
of
Insu
ran
ce C
ov
era
ge
6
mo
nth
s a
fte
r
en
act
me
nt
Pre
ve
nts
insu
ran
ce c
om
pa
nie
s fr
om
wit
hd
raw
ing
co
ve
rag
e w
he
n a
pe
rso
n g
ets
sic
k a
s a
wa
y o
f a
vo
idin
g c
ov
eri
ng
th
e
cost
s o
f e
nro
llee
s h
ea
lth
ca
re n
ee
ds.
Elim
ina
tes
Life
tim
e L
imit
s o
n In
sura
nce
Co
ve
rag
e
6 m
on
ths
aft
er
en
act
me
nt
Pro
hib
its
insu
rers
fro
m im
po
sin
g li
feti
me
lim
its
on
be
ne
fits
.
Re
gu
late
s U
se o
f A
nn
ua
l Lim
its
on
Insu
ran
ce C
ov
era
ge
6 m
on
ths
aft
er
en
act
me
nt
Re
gu
late
s in
sura
nce
pla
ns
use
of
an
nu
al l
imit
s to
en
sure
acc
ess
to
ne
ed
ed
ca
re in
all
gro
up
pla
ns
an
d a
ll n
ew
ind
ivid
ua
l pla
ns.
Ap
plie
s to
all
ne
w p
lan
s in
th
e in
div
idu
al m
ark
et
an
d e
mp
loye
r p
lan
s. I
n 2
01
4, t
he
use
of
an
nu
al
limit
s w
ill b
e b
an
ne
d f
or
ne
w p
lan
s in
th
e in
div
idu
al m
ark
et
an
d a
ll e
mp
loye
r p
lan
s.
Co
ve
rag
e f
or
Yo
un
g A
du
lts
6 m
on
ths
aft
er
en
act
me
nt
Re
qu
ire
s h
ea
lth
pla
ns
tha
t p
rov
ide
co
ve
rag
e f
or
child
ren
to
co
nti
nu
e t
o m
ake
th
at
cov
era
ge
av
aila
ble
un
til t
he
ch
ild
turn
s 2
6 y
ea
rs o
f a
ge
. Th
e r
eq
uir
em
en
t a
pp
lies
to a
ll p
lan
s in
th
e in
div
idu
al m
ark
et,
ne
w e
mp
loye
r p
lan
s, a
nd
exi
stin
g
em
plo
yer
pla
ns
u
nle
ss t
he
ad
ult
ch
ild h
as
an
off
er
of
cov
era
ge
th
rou
gh
his
or
he
r e
mp
loye
r. B
oth
ma
rrie
d a
nd
un
ma
rrie
d c
hild
ren
qu
alif
y fo
r th
is e
xte
nd
ed
co
ve
rag
e. B
eg
inn
ing
in 2
01
4, i
nd
ivid
ua
ls u
p t
o a
ge
26
ca
n s
tay
on
th
eir
pa
ren
ts e
mp
loy
er
pla
n e
ve
n if
th
ey
ha
ve
an
off
er
of
cov
era
ge
th
rou
gh
th
eir
em
plo
yer.
Re
du
cin
g C
ost
of
Ea
rly
Re
tire
me
nt
90
da
ys a
fte
r e
na
ctm
en
t C
rea
tes
a n
ew
te
mp
ora
ry r
ein
sura
nce
pro
gra
m t
o h
elp
off
set
the
co
sts
of
exp
en
siv
e p
rem
ium
s fo
r e
mp
loye
rs a
nd
reti
ree
s fo
r h
ea
lth
be
ne
fits
fo
r re
tire
es
ag
e 5
5-6
4.
In 2
01
4, r
eti
ree
s b
etw
ee
n 5
5-6
4 w
ill b
e e
ligib
le t
o p
art
icip
ate
in t
he
he
alt
h in
sura
nce
exc
ha
ng
e.
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-
Imp
rov
ing
Co
nsu
me
r In
form
ati
on
Ju
ly 1
, 20
10
R
eq
uir
es
the
Se
cre
tary
of
He
alt
h a
nd
Hu
ma
n S
erv
ice
s to
est
ab
lish
an
Inte
rne
t w
eb
site
th
rou
gh
wh
ich
re
sid
en
ts o
f a
ny
Sta
te m
ay
ide
nti
fy a
ffo
rda
ble
he
alt
h in
sura
nce
co
ve
rag
e o
pti
on
s in
th
at
Sta
te.
Imp
rov
ing
Co
nsu
me
r A
ssis
tan
ce
Up
on
en
act
me
nt
Re
qu
ire
s th
e S
ecr
eta
ry o
f H
ea
lth
an
d H
um
an
Se
rvic
es
to a
wa
rd g
ran
ts t
o S
tate
s to
est
ab
lish
he
alt
h in
sura
nce
con
sum
er
ass
ista
nce
or
om
bu
dsm
an
pro
gra
ms
to r
ece
ive
an
d r
esp
on
d t
o in
qu
irie
s a
nd
co
mp
lain
ts c
on
cern
ing
he
alt
h
insu
ran
ce c
ov
era
ge
.
Ap
pe
als
Pro
cess
fo
r D
en
ial o
f C
ov
era
ge
6
mo
nth
s a
fte
r
en
act
me
nt
Re
qu
ire
s n
ew
pla
ns
to im
ple
me
nt
an
eff
ect
ive
inte
rna
l an
d e
xte
rna
l ap
pe
als
pro
cess
fo
r co
ve
rag
e d
ete
rmin
ati
on
s a
nd
cla
ims.
He
alt
h In
sura
nce
Tra
nsp
are
ncy
6
mo
nth
s a
fte
r
en
act
me
nt
Wit
h t
he
exc
ep
tio
n o
f e
mp
loye
rs t
ha
t se
lf-i
nsu
re, a
ll h
ea
lth
pla
ns
mu
st r
ep
ort
on
th
e s
ha
re o
f p
rem
ium
do
llars
sp
en
t
on
me
dic
al c
are
ve
rsu
s o
the
r e
xpe
nse
s, s
uch
as
sala
rie
s a
nd
ad
min
istr
ati
ve
co
sts
t
he
ir m
ed
ica
l lo
ss r
ati
o (
MLR
).
Be
gin
nin
g n
ot
late
r th
an
Ja
nu
ary
1, 2
01
1, p
lan
s th
at
exc
ee
d li
mit
s o
n o
ve
rhe
ad
mu
st p
rov
ide
co
nsu
me
r re
ba
tes
if
the
y fa
il to
me
et
the
MLR
sta
nd
ard
.
Lon
g-T
erm
Ca
re In
sura
nce
Ja
nu
ary
1, 2
01
1
Cre
ate
s a
lon
g-t
erm
ca
re in
sura
nce
pro
gra
m t
o b
e f
ina
nce
d b
y v
olu
nta
ry p
ayr
oll
de
du
ctio
ns
to p
rov
ide
ca
sh b
en
efi
ts
to a
du
lts
wh
o b
eco
me
dis
ab
led
.
He
alt
h In
sura
nce
Re
gu
lati
on
s Ja
nu
ary
1, 2
01
4
Imp
lem
en
ts s
tro
ng
he
alt
h in
sura
nce
re
form
s th
at
pro
hib
it in
sura
nce
co
mp
an
ies
fro
m r
efu
sin
g t
o s
ell
cov
era
ge
or
ren
ew
po
licie
s b
ase
d o
n a
n in
div
idu
als
he
alt
h s
tatu
s. In
sure
rs c
an
no
lon
ge
r e
xclu
de
co
ve
rag
e f
or
tre
atm
en
ts b
ase
d
on
pre
-exi
stin
g h
ea
lth
co
nd
itio
ns.
It a
lso
lim
its
the
ab
ility
of
insu
ran
ce c
om
pa
nie
s to
ch
arg
e h
igh
er
rate
s d
ue
to
he
ath
sta
tus,
ge
nd
er,
or
oth
er
fact
ors
. Pre
miu
ms
can
va
ry o
nly
by
ag
e (
no
mo
re t
ha
n 3
:1),
ge
og
rap
hy,
fa
mily
siz
e, a
nd
tob
acc
o u
se.
He
alt
h In
sura
nce
Exc
ha
ng
e
Jan
ua
ry 1
, 20
14
R
eq
uir
es
the
est
ab
lish
me
nt
of
he
alt
h in
sura
nce
exc
ha
ng
es
in e
ach
Sta
te t
o t
he
ind
ivid
ua
l an
d s
ma
ll g
rou
p m
ark
ets
.
Th
is n
ew
ve
nu
e w
ill e
na
ble
pe
op
le t
o c
om
pa
riso
n s
ho
p f
or
sta
nd
ard
ize
d h
ea
lth
pa
cka
ge
s. It
fa
cilit
ate
s e
nro
llme
nt
an
d
qu
alif
ies
ind
ivid
ua
ls f
or
tax
cre
dit
s th
at
ma
ke c
ov
era
ge
mo
re a
ffo
rda
ble
.
Mu
lti-
Sta
te In
sura
nce
Op
tio
n
Jan
ua
ry 1
, 20
14
P
rov
ide
s a
ch
oic
e o
f co
ve
rag
e t
hro
ug
h a
t le
ast
tw
o m
ult
i-S
tate
pla
ns
off
ere
d t
hro
ug
h t
he
he
alt
h in
sura
nce
exc
ha
ng
e,
av
aila
ble
na
tio
nw
ide
, an
d o
ffe
red
by
pri
va
te in
sura
nce
car
rie
rs u
nd
er
the
su
pe
rvis
ion
of
the
Off
ice
of
Pe
rso
nn
el
Ma
na
ge
me
nt.
Ta
x C
red
its
an
d C
ost
-Sh
ari
ng
Ja
nu
ary
1, 2
01
4
Ma
kes
pre
miu
m t
ax
cre
dit
s a
nd
co
st-s
ha
rin
g r
ed
uct
ion
s a
va
ilab
le t
hro
ug
h t
he
he
alt
h in
sura
nce
exc
ha
ng
es
to h
elp
pe
op
le o
bta
in a
ffo
rda
ble
co
ve
rag
e. P
rem
ium
cre
dit
s a
re a
va
ilab
le f
or
pe
op
le w
ith
inco
me
s a
bo
ve
10
0 p
erc
en
t a
nd
be
low
40
0 p
erc
en
t o
f p
ov
ert
y ($
88
,00
0 f
or
a f
am
ily o
f fo
ur)
wh
o a
re n
ot
elig
ible
fo
r o
r o
ffe
red
oth
er
qu
alif
ied
cov
era
ge
.
Ind
ivid
ua
l Re
spo
nsi
bili
ty
Jan
ua
ry 1
, 20
14
R
eq
uir
es
mo
st in
div
idu
als
wh
o c
an
aff
ord
it t
o o
bta
in a
cce
pta
ble
he
alt
h in
sura
nce
co
ve
rag
e o
r p
ay
a f
ee
to
he
lp o
ffse
t
the
co
sts
of
cari
ng
fo
r u
nin
sure
d A
me
rica
ns.
If a
ffo
rda
ble
co
ve
rag
e is
no
t a
va
ilab
le t
o a
n in
div
idu
al,
the
y w
ill b
e
elig
ible
fo
r a
n e
xem
pti
on
.
En
sure
s C
ov
era
ge
fo
r In
div
idu
als
Pa
rtic
ipa
tin
g in
Clin
ica
l Tri
als
Jan
ua
ry 1
, 20
14
P
roh
ibit
s in
sure
rs f
rom
dro
pp
ing
co
ve
rag
e b
eca
use
an
ind
ivid
ua
l ch
oo
ses
to p
art
icip
ate
in a
clin
ica
l tri
al a
nd
fro
m
de
nyi
ng
co
ve
rag
e f
or
rou
tin
e c
are
th
at
the
y w
ou
ld o
the
rwis
e p
rov
ide
just
be
cau
se a
n in
div
idu
al i
s e
nro
lled
in a
clin
ica
l tri
al.
Ap
plie
s to
all
clin
ica
l tri
als
th
at
tre
at
can
cer
or
oth
er
life
-th
rea
ten
ing
dis
ea
ses.
!
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