http://www.mtxoom.com/health/ Health Care Reform Bill Summary After what seems like forever, Congress has finally passed a health care reform bill. President Obama's major goal for the early part of his term seems within reach. The question is, though, what is in this bill? What real changes will people experience as a result of all this wrangling? Or are these all political games with little real impact? Read on for a summary of the actual changes to health care from the new health reform bill. The most important thing to realize about the reform is that it's phased in - most of the changes don't come into play when President Obama signs the bill into law (which is expected to be Tuesday, March 23, 2009). The changes activate over the next decade. Here are the major changes and their impacts. Health Reform Bill Contents Before 2011: * Small businesses get a tax credit to contribute to new health insurance for employees. * Children cannot be excluded from receiving health insurance from providers due to pre- existing conditions. * Until the new health insurance exchanges come online in 2014, current uninsured adults with pre-existing conditions will be able to buy subsidized health care coverage. * Companies can use a temporary health "reinsurance program" to provide benefits for 55-64 year old retirees. * Being diagnosed with a new illness is no longer grounds for losing your health insurance coverage. Additionally, insurance providers will no longer be able to cap your lifetime health benefits, and their ability to limit annual coverage will be restricted. * There is currently a Medicare prescription drug loophole between roughly $2700 and $6200 worth of medicine. The reform bill both provides a $250 rebate to Medicare beneficiaries that fall into this loophole and provides for the gap's closing. * The age up to which children will be able to use their parents health coverage is raised to 26 up from the previous 19 or college graduation. * Indoor tanning services with ultraviolet lights will see a 10% tax on their services starting July 1st, 2009 In 2011: * Large pharmaceutical firms will be taxed additionally based on market share. * General surgeons and primary care physicians will see a 10% raise in bonus payments. * Medicare advantage payments are frozen at 2010 levels and will eventually come more into line with traditional Medicare payments. * States will have a new program to offer in-home care to poor patients who would otherwise require a hospital visit. * Employees will be able to see the value of their health benefits on their W-2 forms. * An annual free wellness visit and customized prevention plan analysis will be offered free to all Medicare beneficiaries. Any additional new health care plans will be required to offer such services and their resulting preventive care at little or no cost to Medicare patients. In 2012: * At each level, hospital, physician, and Medicare, programs and controls are implemented that reduce readmission rates, improve quality outcomes for patients, and encourage more accountability among healthcare professionals. In 2013: * Higher income tax payers (>$200,000 for singles, >$250,000 for joint filings) will have their payroll tax increase from 1.45% to 2.35% as well as pay a 3.8% investment income tax. * Tax payers can claim medical expenses on itemized tax returns at a 10% rate instead of 7.5%. Elderly tax payers can continue this till 2017. * Non-public medical device taxes will be additionally taxed at 2.9%. * The programs begun in 2012 are continued and extended. In 2014: * Employers with >50 employees will be fined $2000 for every employee after number 30 if they do not provide employer health insurance. * Most people will be fined if they do not have health insurance, either through an employer or privately. Tax credits for purchasing health care through an exchange will be offered to those with incomes up to 400% of poverty levels. * Similar to the 2011 pharmaceutical taxes, in 2014 health insurance companies will be taxed by market share. * It will no longer be legal to exclude someone from receiving health insurance for having a pre-existing medical condition. * State-level health insurance exchanges will open, allowing individuals and organizations to shop around for cheaper health insurance. In 2015: * Medicare shifts to rewarding quality of care rather than amount of services. In 2018: * Higher cost employer health insurance plans ("Cadillac" health insurance) is taxed, with exemptions for the first $27,000 for families and $10000 for individuals.