Why discuss health care in a family law blog? A person’s mental and physical health has a huge impact on their life. Anyone who has been ill themselves or had an ill family member knows that the entire family is affected; not only by the illness and care involved, but by the expense as well.
As we all know, the U.S. Congress passed a significant health care reform proposal. Health care reform, known as “Obamacare”, or by its official name, the Patient Protection and Affordable Care Act (“ACA”), was signed into law on March 23, 2010. Now that this is the law, how will the ACA affect you?
In 2008, the total spent on health care costs in America was $2.3 trillion dollars or $7,681 per person. Between 1965 and 1985, U.S. health care spending (adjusted for inflation) more than tripled; then it nearly tripled again between 1985 and 2005.
In general, the goal of the ACA is to make health insurance available to more people and to lower costs overall. The ACA will 1) require Americans to have health insurance, 2) create state-based health insurance exchanges, 3) require employers to pay penalties if certain requirements are not satisfied, and 4) expand Medicaid. The exchanges are not expected to be effective until 2014; however, there are many parts to this act, and some are starting now.
One of the first things you need to determine regarding your own health care plan is whether or not it is a Grandfathered Health Plan. If you are not in a Grandfathered Plan, then either you are in a New Health Plan, or you are not covered by any plan. A Grandfathered Plan does not have to comply with all of the ACA requirements, whereas a New Health Plan does.
A Grandfathered Health Plan
1. Must have continuously covered someone since March 23, 2010,
2. May not apply for a new policy, certificate or contract of insurance, and
3. Must disclose that it is a Grandfathered Health Plan.
If the plan meets the criteria to be a Grandfathered Health Plan, the plan
1. Cannot Significantly Cut Or Reduce Benefits (Example – plan decides not to cover diabetics);
2. Cannot Raise Co-Insurance Charges (Example – patient pays first 20%);
3. Cannot Significantly Raise Co-Payment Charges (Example – $20 a doctor visit);
4. Cannot Significantly Raise Deductibles.
5. Cannot Significantly Lower Employer Contributions Towards the Cost of Medical Insurance.
6. Cannot Decrease the Annual Limit of What the Insurance Company Pays.