Health Care, Reformed

President Barack Obama walks with the late Sen. Ted Kennedy. | White House photo/<a href="http://www.flickr.com/photos/whitehouse/3484051389/">Pete Souza</a> (<a href="http://www.usa.gov/copyright.shtml">Government Work</a>)


You already know about the Democrats’ big health care reform victory Sunday night, the deal it took to get there, and the debate that will come next. But if you haven’t been paying close attention, you might not know what’s in it for you. America, here’s what you’ve won (and all of this stuff kicks in this year):

  1. Insurance companies can no longer impose lifetime coverage limits on your insurance. Never again will you face the risk of getting really sick and then, a few months in, having your insurer tell you “sorry, you’ve ‘run out’ of coverage.” Almost everyone I’ve met knows someone who had insurance but got really, really sick (or had a kid get really sick) and ran into a lifetime cap.
  2. If you don’t know someone who has run into a lifetime cap, you probably know someone who has run into an annual cap. The use of these will be sharply limited. (They’ll be eliminated entirely in 2014.)
  3. Insurers can no longer tell kids with pre-existing conditions that they’ll insure them “except for” the pre-existing condition. That’s called pre-existing condition exclusion, and it’s out the window.
  4. A special, temporary program will help adults with pre-existing conditions get coverage. It expires in 2014, when the health insurance exchanges—basically big “pools” of businesses and individuals—come on-line. That’s when all insurers will have to cover everyone, pre-existing condition or not.
  5. Insurance companies can’t drop you when you get sick, either—this plan means the end of “rescissions.”
  6. You can stay on your parents’ insurance until you’re 26.
  7. Seniors get $250 towards closing the “donut hole” in their prescription drug coverage. Currently, prescription drug coverage ends once you’ve spent $2,700 on drugs and it doesn’t kick in again until you’ve spent nearly $6,200. James Ridgeway wrote about the problems with the donut hole for Mother Jones in the September/October 2008 issue. Eventually, the health care reform bill will close the donut hole entirely. The AARP has more on immediate health care benefits for seniors. Next year (i.e. in nine months), 50 percent of the donut hole will be covered.
  8. Medicare’s preventive benefits now come with a free visit with your primary care doctor every year to plan out your prevention services. And there are no more co-pays for preventative services in Medicare.
  9. This is a big one: small businesses get big tax credits—up to 50 percent of premium costs—for offering health insurance to their workers.
  10. Insurers with unusually high administrative costs have to offer rebates to their customers, and every insurance company has to reveal how much it spends on overhead.

There’s a lot more that happens down the road. But this is most of what you get now. No death panels included.

THE BIG QUESTION...

as we head into 2020 is whether politics and media will be a billionaires’ game, or a playing field where the rest of us have a shot. That's what Mother Jones CEO Monika Bauerlein tackles in her annual December column—"Billionaires Are Not the Answer"—about the state of journalism and our plans for the year ahead.

We can't afford to let independent reporting depend on the goodwill of the superrich: Please help Mother Jones build an alternative to oligarchy that is funded by and answerable to its readers. Please join us with a tax-deductible, year-end donation so we can keep going after the big stories without fear, favor, or false equivalency.

THE BIG QUESTION...

as we head into 2020 is whether politics and media will be a billionaires’ game, or a playing field where the rest of us have a shot.

Please read our annual column about the state of journalism and Mother Jones' plans for the year ahead, and help us build an alternative to oligarchy by supporting our people-powered journalism with a year-end gift today.

We Recommend

Latest

Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate

We have a new comment system! We are now using Coral, from Vox Media, for comments on all new articles. We'd love your feedback.