H.R. 3590 is called the Patient Protection and Affordable Care Act. The bill was sponsored by Charles Rangel, a Democrat representative from New York. Congress passed the bill into law on December 24, 2009. While many Americans held strong opinions about the bill as it was being debated, there was a lot of false information as to what the bill actually contained. Now that the bill has passed, and is available for viewing on the Library of Congress' website, Thomas.gov, it is important to know what the law does and does not say. This article addresses Title I, Subtitle C, Parts I and II, of the Patient Protection and Affordable Care Act of 2009.
Title I, Subtitle C, Part I: Every American is Guaranteed Quality Health Insurance Coverage
Title 1, Subtitle C, Pat I, prohibits health insurance plans from excluding preexisting conditions or denying health insurance coverage on the basis of any health-related factor, unless the health care plan is "grandfathered."
This means an employee of a company with a preexisting condition cannot be denied health insurance unless the company's health insurance provider does not cover preexisting conditions under an older law or policy. The only factors that can be considered when deciding what to charge for health insurance premiums are individual or family coverage, competition according to the plan area, age, and smoking.
Health insurance companies must now accept every person in a state who applies for coverage, and renew this coverage as applicable. Health insurance companies may not deny health insurance on the basis of medical condition, history or genetics. Neither can a health insurance company deny an individual coverage based on ability to pay medical bills or past experiences with claims.
Wellness programs will be provided under the new federal health care plan. The cost of health insurance may go down if a patient decides to participate in a program like this. Health insurance companies may not discriminate against any doctor or other health care provider who is acting within the capacity of his or her state license or certification to practice.
Essential health benefits must be provided to individuals and small business markets. There are limits on the cost of providing health insurance to this market. No "waiting period" for health insurance may exceed 90 days. No individual may be discriminated against for participating in a clinical trial for the treatment of a life-threatening medical condition.
Title I, Subtitle C, Part II: "Grandfathered" Health Insurance Plans
No American will be forced to terminate his or her current health insurance plan coverage. If the health insurance company updates its policies and coverage plans to meet the new federal guidelines,
Americans have the option of staying with their current health insurance provider, called a "grandfathered health plan." New employees and their families will enroll in health insurance plans that meet the new federal guidelines.
Subtitle A and C do not apply to health plans who have collective bargaining agreements between employee representatives and their employers that went into effect before December 24, 2009. Those agreements will remain as they are until their contracts expire.
Sec. 1252 states that all health plans must adopt uniform standards and requirements. Sec. 1253 says that the Department of Labor must provide annual reports on health care plans for the self- insured employer. Sec. 1254 says that the Department of Health and Human Services will study both fully-insured and self-insured health care plan markets to determine financial solvency and how the federal reforms are affecting the insurance market. Sec. 1255 sets deadlines for the specifics of Subtitle C.
Source
Thomas.gov, Library of Congress: "Bill Summary and Status, 111th Congress (2009-2010), H.R. 3590 CRS Summary"
Donna Pravel - Donna Earnest Pravel is the owner and senior editor of www.Heart of Texas Copywriting Solutions.com.
Join the Conversation