Major Health Care Reforms Take Effect January 1

[Joanne98]

Starting Saturday, two of the new health care law's most significant reforms take effect -- or at least begin to take effect.

The first will dramatically clamp down on insurance industry waste, abuse, and excesses. Starting on New Year's Day, insurance companies will have to spend at least 80 percent of the revenues they receive from premiums on actual health care. Not on salaries or overhead.

Like so many of the law's early reforms, the impact of a strict "medical loss ratio" will be invisible to most consumers. But don't mistake that for insignificance. The bill's most strident critics cite this one provision as the basis for the claim that the government is "taking over" the health care system. That's a false claim, no matter how you slice it -- this is about insurance companies, not, say, hospitals or pharmaceuticals, and those insurers are all still private. They'll just have to play by stricter rules.

The other is much more visible. Senior citizens -- a demographic that's skeptical of the bill -- will see real benefits. In 2011, the law will begin to close the Medicare Part D coverage gap -- the infamous "donut hole." Seniors who reach the donut hole will now receive a 50 percent discount on brand-name drugs, the first step in a 10 year plan to fill the hole completely. Seniors will also now receive free annual checkups, screenings and other preventive care.

http://tpmdc.talkingpointsmemo.com/2010/12/major-health-care-reforms-take-effect-january-1.php

[Oceansaway]

1. K&R...n/t

[hlthe2b]

2. Any forward movment is good, but with now 50 million uninsured...

states trying desperately to knock even more off of medicaid eligibility, I'm having a hard time being optimistic. I'd like to be, though....:shrug:

[Mulhane]

3. Nothing for "Tweens" until 2014?

The battered Boomers still too young to get Medicare or even early retirement need some help on this more than the elderly, but what does this Bill do for us in the next 3-4 years?

[mmonk]

4. Not much really though my premium increase was a little less

than last year's.

[mbperrin]

5. Our BCBS for this year is $500 per year increase in premiums, with

double deductibles and double out of pocket from last year. Generics went from zero to $10; rest of prescriptions went from $10 to $35.

[Kennah]

6. My premiums are down ...

... but they dropped RX drug coverage to deliver that "benefit". We now have a RX drug discount card. They did offer to "upgrade" to a comprehensive plan--for double the premium.

We also have the State of Washington's RX discount card, and it's free to every Evergreen Stater. Get one of my meds through them, and it's the best price I've found.
http://www.rx.wa.gov/

For other maintenance meds, the wife and I have gone Canadian.

[eridani]

7. Since the insurance companies provide the data to calculate MLR--

--expect this to be a huge flop, the same as it has been for the 15 states that have already tried it. Naturally the insurance companies resent having to spend extra money and effort on data-fudging, but this has fuckall to do with the outrageous hikes in premiums.