Health law’s obscure, common traits explained

Speaker strives to clarify what federal reform law will, won’t do, and when

By Marissa Harshman, Columbian health reporter

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A couple dozen Clark County residents learned about some of the obscure elements and more common components of federal health care reform at a presentation Monday night.

Among the obscure: a new tax on indoor tanning, pumping breast milk at the workplace becoming a federally protected right, and tax credits for people who adopt children.

Among the more well-known: young adults can stay on their parents’ insurance plan until age 26, children and adults cannot be denied health insurance due to pre-existing conditions, and tax credits for small businesses offering health insurance to their employees.

Bianca Stoner, an analyst and consumer advocate at the Office of the Washington State Insurance Commissioner, provided those tidbits during a 90-minute presentation on the Patient Protection and Affordable Care Act, more commonly referred to as health care reform. Clark County Public Health hosted the event.

Stoner explained the components of health care reform that have already gone into effect and what changes are still to come.

Some insurance plans have been “grandfathered” and won’t be required to implement all of the changes until full reform goes into effect Jan. 1, 2014. But for the plans that are not grandfathered, here are some changes that have already been made:

• As of October 2010, insurance companies cannot deny children coverage due to pre-existing conditions. As a result, some insurance companies said they wouldn’t insure kids at all. The state insurance commissioner, however, prohibited the action, Stoner said.

• As of Sept. 23, 2010, children can remain on their parents’ insurance plan until age 26. Parents can add their adult child at the time of their plan renewal so long as the child doesn’t have an offer for insurance through their own employer, Stoner said. In 2014, adult children can remain on the plan even if they have another offer for insurance, she said.

• Adults with serious pre-existing conditions can join the state’s Pre-Existing Insurance Pool. Most of the plan’s current 500 members have serious conditions such as cancer or are pregnant, Stoner said.

• As of Oct. 23, 2010, insurance companies cannot impose lifetime limits on essential coverage. Also, annual limits on essential coverage will increase each year, Stoner said. The only glitch: the federal government has yet to define “essential coverage,” but that definition will come, Stoner said.

• Insurance plans and Medicarehave to offer preventive care such as immunizations, well-baby and annual check-ups at no cost to the patient, Stoner said.

Here are some additional changes to expect when full reform goes into effect Jan. 1, 2014:

• Insurance companies cannot deny adults coverage or impose lengthy waiting periods for acceptance due to pre-existing conditions.

• Small businesses with 25 or more employees can get a tax credit for providing insurance coverage to employees.

• Washington state will have its own insurance exchange that requires certain categories of health plans to all offer the same elements. This will make it easier for consumers to compare plans apples-to-apples, Stoner said. “Navigators” will help guide consumers through the exchange, she said.

• Subsidies will be available to help people purchase individual insurance coverage. People earning up to 400 percent of the poverty level (a single person making $42,000 per year) will be eligible, Stoner said.

• Businesses with 50 or more employees that don’t provide insurance coverage will be penalized if even one employee purchases coverage through the exchange, Stoner said.

For more information about health care reform, visit Clark County Public Health at http://www.clark.wa.gov/public-health/insurance/health_reform.html or the Office of the Insurance Commissioner at http://www.insurance.wa.gov.

Marissa Harshman: 360-735-4546; http://twitter.com/col_health; http://facebook.com/reporterharshman; marissa.harshman@columbian.com.