Health — 19 July 2012
Benefits of the Affordable Care Act (ObamaCare)

1. Prevents denial of coverage to children with pre-existing conditions.

2. Adults up to age 26 can stay on their parents’ health plans.

3. Requires new health plans to provide free preventive care without cost-sharing such as co-pays or deductibles. HHS issued interim final regulations on preventive services and amendment to the final regulations.

4. Prohibits rescinding coverage making it illegal.

5. Prohibits lifetime limits on the dollar value of insurance coverage.

6. Prohibits annual limits on insurance coverage.

7. More options to appeal coverage decisions.

8. Provides $5 billion in immediate federal support to affordable Coverage for the Uninsured with Pre-existing Conditions.

9. Provides a $10 billion investment in Community Health Centers to expand medical services.

10. Create immediate access to re-insurance for employer health plans providing coverage for early retirees over age 55 who are not eligible for Medicare. 11. Implemented a process that requires states to review insurance companies premium increases. The final rule for the insurance rate review program was published in the Federal Register on May 19, 2011.

12. Provided grants worth almost $250 million ($46 million and $199 million) to assist States enforce the insurance rate review program.

13. Provides tax credits or grants to employers with 250 or fewer employees for up to 50% of the investments costs in projects that qualifying Therapeutic Discovery Project. About a $1 billion in tax credits and grants have been provided by end of 2010.

14. Appropriated $5 billion for fiscal years 2010 through 2014 and $2 billion for each of the subsequent five fiscal years to support prevention and public health programs.

15. Provides a $250 rebate to 750,000 Medicare Beneficiaries who reach the Part D coverage gap in 2010. As of March 22, 2011, 3.8 million beneficiaries had received a $250 check to close the coverage gap, according to an HHS report.

16. Requires pharmaceutical manufacturers to provide a 50% discount on brand-name prescriptions and a 7% and 14% generic drug discount (in 2011 and 2012, respectively) filled in the Medicare Part D coverage gap.

17. Businesses with fewer than 25 employees will get tax credits covering up to 35% of employee premiums effective 2011 and a 50% tax credit effective 2013.

18. Creates a state option to provide Medicaid coverage to childless adults with incomes up to 133% of the federal poverty level. By 2014, States are required to provide this coverage.

19. Provides a 10% Medicare bonus payment for primary care services and to general surgeons practicing in health professional shortage areas.

20. Requires insurance companies spend at least 80 to 85 percent of the proportion of the premium dollars on clinical services and issue a rebate if the share of the premium spent is less than the threshold.

21. Creates a temporary program to provide health coverage to individuals with pre-existing medical conditions who have been uninsured for at least six months.

22. Imposes a tax of 10% on the amount paid for indoor tanning services.

23. Expands eligibility for the 340(B) drug discount program to sole community hospitals, critical access hospitals, certain children’s hospitals, and other entities with a savings estimated to be 20% to 50% on the cost of pharmaceuticals and reaching more eligible patients while providing more comprehensive services.

24. Eliminates cost sharing for Medicare – covered preventive services that are recommended (rated A or B) by the U.S. Preventive Services Task Force. As of October 6, 2011, Centers for Medicare and Medicaid Services (CMS) reported that 20.5 million people had participated in the free Annual Wellness Visit.

25. Provides 3-year grants worth $100 million to states to develop programs for Medicaid enrollees with incentives to participate in comprehensive health lifestyle programs.

26. Awarded $185 million worth of grants as of August 2011 to states to begin planning for the establishment of American Health Benefit Exchanges and Small Business Health Options Program Exchanges, which facilitate the purchase of insurance by individuals and small employers.

27. Requires disclosure of the nutritional content of standard menu items at chain restaurants and food sold from vending machines.

28. Imposes new annual fees on the pharmaceutical manufacturing sector. The sector will be assessed at the following rates: $2.8 billion in 2012 through 2013, $3 billion in 2014 through 2016, $4 billion in 2017, $4.1 billion in 2018 and $2.8

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