"The proposal we’ve put forward would end the worst practices of the insurance industry, lower costs for millions of Americans, and give uninsured individuals and small businesses the same kind of choice of private health insurance that Members of Congress get for themselves.First-year Health Care Changes
"And while it will take a few years to fully implement these reforms, there are numerous protections and benefits that would start to take effect this year."
In his address, the President specifically mentioned a number of first-year health care changes that would result from passage of his proposal, including:
- "Small business owners will receive tax credits to purchase health insurance."
- "Thousands of uninsured Americans with pre-existing conditions will finally be able to purchase coverage."
- "Insurance companies will no longer be allowed to deny coverage to children with pre-existing conditions."
- "They will no longer be allowed to drop your coverage when you get sick."
- "All new insurance plans will be required to offer free preventive care to their customers."
- "There will no longer be lifetime limits or restrictive annual limits on the amount of care you receive."
- "Young adults will be able to stay on their parents’ insurance policy until they’re 26 years old."
- "There will be a new, independent appeals process for anyone who feels they were unfairly denied a claim by their insurance company."
- "Finally, seniors who fall into the gap in coverage known as the donut hole will receive $250 to help them pay for their prescriptions."
- Hold Insurance Companies Accountable:
- Eliminate lifetime limits and restrictive annual limits on benefits in all new plans;
- Prohibit rescissions of health insurance policies in all individual plans;
- Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs;
- Establish a process for the annual review of unreasonable increases in premiums, requiring State insurance commissioners to work with the HHS Secretary and States.
- Protect Consumers:
- Provide grants to States to support health insurance consumer assistance and ombudsman programs to help consumers;
- Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions;
- Require all insurance plans to use uniform coverage documents so consumers can make easy comparisons when shopping for health insurance;
- Establish an internet portal to assist Americans in identifying coverage options;
- Prohibit insurers from discriminating in favor of highly compensated employees by charging them lower premiums.
- Ensure Affordable Choices and Quality Care:
- Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool;
- Create a temporary re-insurance program for early retirees;
- Require new plans to cover preventive services and immunizations without cost-sharing;
- Facilitate administrative simplification to lower health system costs.