24
Mar
10

CNN Answers health care questions

With the passage of the health care reform bill, CNN has been flooded with viewer questions about specifics of the measure and how their lives may be affected. In response, we’re providing answers here, based on our reporting research, that address some of the issues you’re raising most often. Got another question? E-mail us at healthcare@cnn.com.

Question: Can you explain whether the elimination of lifetime caps under the new health care bill applies to existing policy-holders as well as new insurance sign-ups?

Answer: Yes, within six months, the private insurance plans will have to stop some practices, such as setting lifetime limits on coverage and canceling policy-holders who get sick, on all new policies and current policies.

Question: I have been watching all of the debating. I still cannot figure out, what does this mean to me? I’m an unemployed 56-year-old. Lost my health care. Cannot afford COBRA. Now, what is there for me? I have a daughter in college. My insurance company refused to pay for therapy on my knees, calling it pre-existing. My unemployment just ran out. Now what?

Answer: When the insurance exchange opens, as required by the health care bill, people who are self-employed or whose employers don’t offer coverage can purchase a plan. If you lost a job, you could get insurance through this new marketplace. Also, once this exchange opens, private insurers will no longer be able to turn away people with medical problems or charge them more. Individuals would be required to purchase coverage or face a fine of up to $695 or 2.5 percent of income, whichever is greater, starting in 2016. The plan includes a hardship exemption for poorer Americans. Exemptions will be granted for financial hardship, those for whom the lowest-cost option exceeds 8 percent of an individual’s income and those with incomes below the tax filing threshold (in 2009, the threshold for taxpayers under age 65 was $9,350 for singles and $18,700 for couples).

Question: What happens to the cost of insurance to the company that is providing the insurance to the employee? Is there a set amount or percentage of the total premium that the employer is required to pay? Will it change the mix that already exists between employer and employee responsibility?

Answer: By no later than 2014, states will have to set up Small Business Health Options Programs, or SHOP exchanges, in which small businesses will be able to pool together to buy insurance. Small businesses are defined as those with no more than 100 employees, though states have the option of limiting pools to companies with 50 or fewer employees through 2016; companies that grow beyond the size limit will also be grandfathered in. But until the SHOP exchanges are set up, there will be a tax break for small businesses that goes into effect right away: Tax credits of 35 percent to 50 percent of premiums will be available to small businesses that offer coverage.

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