Patient Protection & Affordable Care Act

When President Obama signed The Patient Protection and Affordable Care Act into law on March 23, 2010, certain aspects went into effect immediately or almost immediately:

There will be effective 90 days after enactment, federal support for a new program to provide affordable coverage to uninsured Americans with pre-existing conditions. Coverage under this program will continue until new Exchanges are operational in 2014.

There will be immediate investment in Community Health Centers to provide the funding needed to expand access to health care in underserved communities. The investment begins in 2010 and extends for five years.

Effective six months after enactment, the law prohibits health insurers from excluding coverage of pre-existing conditions for children. This applies to all new plans. The elimination of the pre-existing condition exclusion for everyone begins in 2014, when the Exchanges are operational.

Effective 90 days after enactment , the law creates immediate access to re-insurance for employer health plans providing coverage for early retirees,. This re-insurance will help protect coverage while reducing premiums for employers and retirees.

The law will reduce the size of the “donut hole,” in the Medicare (Part D) Drug Benefit. And beginning July 1, 2010 the law will also guarantee 50 percent price discounts on brand-name drugs and biologics purchased by low and middle-income beneficiaries in the coverage gap,.

Beginning in 2010 the law will offer Tax credits of up to 35 percent of premiums to firms that choose to offer coverage. Later, when Exchanges are operational, tax credits will be up to 50 percent of premiums.

Taking effect six months after enactment, the law will protect a patients’ choice of doctors by allowing plan members to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.

Taking effect six months after enactment and applying to all new plans, the law will require insurers to permit children to stay on family policies until age 26.

Taking effect six months after enactment and applying to all new plans, the law will require coverage of prevention and wellness benefits and exempt these benefits from deductibles. And beginning January 1, 2011, Medicare beneficiaries will receive a free, annual wellness visit and will have all cost-sharing waived for prevention services.

Taking effect six months after enactment and applying to all new plans, the law will prohibit insurers from imposing lifetime limits on benefits. And the law will restrict insurance companies’ use of annual limits. These restrictions will be defined by the Secretary of Health and Human Services. When the Exchanges are operational, the use of annual limits will be banned.

Taking effect six months after enactment and applying to all new plans, the law stop insurers from rescinding insurance when claims are filed, except in cases of fraud or intentional misrepresentation of material fact.

Within six months of enactment, under the law, all new health plans will implement, an effective process for appeals of coverage determinations and claims. States will provide an external appeals process to ensure an independent review.

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