What the federal health reform legislation means for Washington state

The health care reform bill passed by the U.S. House Sunday will cut the number of uninsured in Washington state by more than 500,000, provide better coverage to those with insurance, and save $500 million in uncompensated care – health care that’s delivered in Washington state but not directly paid for.

“For decades, our health care system has failed millions of people – driving them and their families into bankruptcy, letting treatable diseases fester into health crises, and invisibly leeching billions of dollars from our economy,” said Washington state Insurance Commissioner Mike Kreidler. “The health care reforms passed today will transform our country and our state.”

The law includes many reforms that will take place quickly (in most cases within 6 months):

• No more denials of coverage for children with pre-existing medical conditions.

• No more $1 million lifetime cap on benefits.

• No more co-pay for preventive care.

• Medicare beneficiaries will get a $250 rebate to help pay prescription drug costs once they hit the “doughnut hole,” a gap in coverage after the first $2,830 a year in benefits. Starting next year, seniors will get a 50 percent discount on brand-name drugs. The gap will be eliminated by 2020.

• Dependent coverage is extended to age 26.

• The bill provides $5 billion to make coverage for people in high-risk pools more affordable, likely in the form of subsidies.

Additional reforms taking place Jan. 1, 2014:

• We’ll receive nearly $13.8 billion in federal assistance to help Washingtonians afford coverage.

• Childless adults would be covered by Medicaid for the first time.

• Individuals buying their own health insurance will no longer have to take a health screen for pre-existing conditions – they’ll be guaranteed coverage.

• Limits on what insurers can charge for out-of-pocket costs.

• Small businesses will get tax credits to help them buy health care.

• Medicare reimbursements to doctors and other providers will improve.

“This is a victory for the many individuals and families who’ve struggled for years without access to affordable health care,” said Kreidler. “With health care consuming one-sixth of our nation’s economy, the reforms passed today will help speed our economic recovery.”

Update: (3/25): The Associated Press is now reporting that due to the wording of the law re: children with pre-existing conditions, it now appears that insurers will, for the time being, still be able to refuse coverage for these children. "Administration officials are now scrambling to fix" the gap, the AP reports.
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