Panel: Health care changes coming soon
SANDPOINT — Local business owners will be changing the way they offer health care options to their employees within the next few years
With several changes to American health care imminent, medical professionals previewed the adjustments at a Greater Sandpoint Chamber of Commerce luncheon Thursday.
Surgeon Mark Savarise outlined the changes introduced by the 2010 Affordable Care Act.
“Some people believe it doesn’t do enough,” Savarise said. “Others believe it does too much.”
Several service-related changes introduced by the legislation are already in effect. Medicare and insurance providers are now required to cover preventative care services like cancer screenings 100 percent. It also filled the Medicare “donut hole,” a limit to prescription drug coverage that sometimes prevented beneficiaries from accessing necessary medication. Primary care providers in rural areas now see increased payment. Finally, individuals age 26 or younger are permitted to remain on their parents’ health care plan.
The act also set some additional restrictions on insurance providers that are currently implemented. It restricts an agency’s ability to set annual and lifetime coverage limits and requires that 85 percent of premiums go to health care services.
Finally, the act boosted federal funds for Medicaid and introduced tax credits for small businesses offering health insurance.
In 2012, additional Affordable Care Act changes are slated for introduction. Most prominently, the year will debut revisions for accountable care organizations, a reform model that attempts to ensure quality and lower costs for an assigned population of patients. Starting this month, ACOs are able to contract with Medicare.
Savarise said the biggest changes are set for 2014.
Most prominently, the health insurance exchange system goes into effect. These state-regulated and standardized health plans will be eligible for federal subsidies. Since a public health care plan was dropped from the legislation, plans qualifying for the exchange system will be privately operated.
In addition, 2014 will be the year of the individual mandate, the requirement that U.S. citizens purchase a health care plan. Citizens with health plans will receive tax credits, while employers who don’t provide insurance will be hit with penalties.
“The big question is whether or not we’ll actually see any of this,” Savarise said.
The Supreme Court will likely rule on the constitutionality of the Affordable Care Act this year. It’s also possible that Congress could de-fund provisions contained within the legislation.