for West Virginia. It's the same for other states.
Top 10 Benefits FOR WEST VIRGINIANS THAT Begin in 6 Months or Less
Making Health Coverage More Affordable for West Virginia’s Small
Businesses. Within six months of enactment, small businesses in
West Virginia will have access to tax credits for up
to 35 percent of the cost of health coverage for their employees.; While
small businesses make up 82 percent of businesses in West Virginia, only 37
percent of them offered health coverage to their employees in 2008.; This
bill could help as many as 20,000 small businesses in West Virginia afford to
offer health coverage.
Significant Help for West Virginians
Denied Coverage Due to Pre-existing Conditions.; Within 90 days of
the bill’s enactment, individuals with pre-existing conditions who are
denied health coverage will have access to affordable and meaningful health
coverage through a high-risk pool.; West Virginians
have the highest rates of diabetes and heart disease in the country, with
one-third of the total population of the state exhibiting high blood
pressure.; These are all pre-existing conditions for which health coverage
can be, and often is, denied. A complete prohibition on insurance company
pre-existing condition exclusions will begin in 2014, when the state health
insurance exchanges are operational.
New Immediate Protections for West Virginias Children Suffering
from a Pre-existing Condition.; Effective immediately, health
insurers will be prohibited from denying coverage for children under age 19
due to a pre-existing condition.; Almost one-third of children and youth
with special health care needs are considered to be underinsured- many of
them because they are denied the coverage they need due to a pre-existing
condition.
Stable Coverage for West Virginia’s Children and Young Adults.;
For plan years beginning six months after enactment, health insurers that
provide dependent coverage for children are required to continue providing
that coverage until the child turns 26 years of age. Young adults just
starting out will no longer be ignored by our health care system.
Protection for West Virginians against Abusive Health Insurance Rescissions.;
Within six months of enactment, insurance companies in all markets are banned from dropping your
coverage once you get sick (rescissions).; All 1.8 million
West Virginians can rest assured that their health insurance
coverage will not be rescinded when they need it most.
Protection of Health Coverage for West Virginia’s Early Retirees.
As soon as practicable upon enactment, the Secretary of Health and Human
Services is required to create a new, temporary reinsurance program to help
companies that provide early retiree health benefits for those ages 55-64 to
offset the expensive cost of that coverage. An estimated 41,500 people from West Virginia have early
retiree coverage through their former employers, but early retiree coverage
has eroded over time.; A reinsurance program provides a backstop of
additional federal funding in the event an employer is liable for
significant health insurance claims that they simply cannot afford to pay.
The reinsurance program included in the health reform bill would stabilize
early retiree coverage and provide premium relief to both early retirees and
the workers in the firms that provide their health benefits. This could
save West Virginia families up to $1,200 on premiums.
Providing Value for the Health Insurance Premiums that
West Virginians Pay. Beginning in 2010, insurers in
the large group market are required to spend a minimum of 85 cents of every
premium dollar paid on medical care, rather than on marketing campaigns or
profits. Insurers in the small group and individual market are required to
spend a minimum of 80 cents of every dollar on medical care. Insurers that
do not abide by these minimum limits would be required to refund consumers
the balance of the premium that should have gone towards medical care.
Insurers in West Virginia currently spend an average of 65 cents of every dollar
on medical care in the individual market and only about 75 cents of every dollar
on medical care in the small group market. West Virginians
can rest assured that the vast majority of the hard-earned dollars they pay
to private health insurance companies will go towards actual medical care.
No Annual or Lifetime Dollar Limits on Health Coverage for
West Virginians.; Within six months of enactment, the
bill bans lifetime dollar limits on coverage, and tightly restricts the use
of annual dollar limits to be sure individuals can access needed care.; The
bill will completely prohibit annual dollar limits on coverage beginning in
2014, when the state health insurance exchanges are operational.
Access to Free Preventive Health Services for
West Virginians.; Within six months of
enactment, all new health plans must include coverage of preventive services
and immunizations free of charge (i.e. health insurers cannot charge a
co-payment).; An estimated 45 percent of West Virginians have not had a colorectal screening, and
23 percent of women over 50 have not had a breast cancer screening. This
provision will make life-saving health screenings more affordable for West Virginians.
Substantial Reduction in West Virginia Seniors
Prescription Drug Costs.; In 2010, West Virginia seniors who fall
into the Medicare prescription drug coverage gap (the doughnut hole) will
receive $500 towards their prescription drug coverage.; Also, starting in
2010, West Virginia seniors who fall into the coverage gap will receive a 50
percent discount on brand name drugs and biologics. According to West
Virginia AARP, roughly 135,000 West Virginias fall into this coverage gap
each year.
More changes and years implemented
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