What You Need to Know About Health Care Reform

Frequently asked questions about health care reform

Everyone is talking about health reform. But how will it affect you? Although we don’t have all the answers yet and probably won’t for some time, here is a summary of how the legislation currently stands.  

What will the new law do?

• It will reduce the number of Americans who don’t have health insurance. The new law is estimated to result in 32 million more insured Americans, (leaving 23 million still uninsured) by:    
  • giving more government subsidies to lower income people,
  • starting in 2010, requiring that a parent’s health insurance plan will cover their children until they are 26 years old
  • starting in 2014, requiring all individuals to have health insurance (with exceptions for certain circumstances),
  • starting in 2014, requiring insurance companies to insure everyone regardless of their medical status, and
  • starting in 2014, requiring all states to have an insurance exchange offering good coverage at affordable prices.

How will this be paid for?

• The costs of the additional subsidies and quality payments will be paid for by:
  • taxing high benefit insurance policies,  
  • taxing higher income people,
  • taxing insurance companies on their premium revenue, and
  • reducing the amount of money now used for the Medicare Advantage program.

How will this affect my TRICARE benefits?

• We do not expect federal health care reform legislation to negatively impact TRICARE Prime, and have been assured by Secretary of Defense Gates that “our troops and their families can be re-assured that the health care reform legislation being passed by the Congress will not negatively impact the TRICARE medical insurance program, as it already meets the bill's quality and minimum benefit standards.
• A new bill is being proposed in the House and Senate to clarify that TRICARE Prime meets all the health reform requirements for individual health insurance. Martin’s Point will be advocating for passage of new proposals to ensure the same benefits or better for our TRICARE Prime members.

 How will this affect Medicare Advantage?

• The new law will provide a $250 rebate to people who trigger the donut hole, and provide more coverage for Part D (prescription drug coverage) by reducing the “donut hole”.
• The law will, over time, reduce the total amount of money that Congress will pay for Medicare Advantage program. While it is likely that, across the country, Medicare Advantage premiums will increase and benefits will be reduced, the impact in Maine will be less because we have what are considered low-cost Medicare counties. This shift in funds will help Congress to provide more insurance to more people who are not eligible for Medicare Advantage, including low and middle income families who are uninsured.
• The new law will not make any changes to our Generations Advantage plans for 2010.
• We are waiting for final word from Medicare regarding any changes that will take effect in January of 2011. We will be contacting our members to let them know of any changes in the fall of 2010. We will continue to design our plans with our members’ health and financial interests as our top priorities. 

Last updated on March 29th, 2010.