As we continue to analyze the new healthcare law, we have prepared these frequently asked questions to help Blue Cross and Blue Shield members better understand what healthcare reform will mean to them. These answers are meant to provide guidance. You should consult legal and tax experts to understand how the law will affect your individual or business circumstances.
I currently have health insurance coverage through a Blue Cross and Blue Shield Plan, do I need to do anything now?
No. The new law will be implemented over the next several years. Blue Cross and Blue Shield companies will continue to provide excellent service and will work to implement the new healthcare laws to best serve their members.
The 38 independent Blue Cross and Blue Shield companies are reviewing the legislation and any potential impact on our members. We will also be working to ensure a smooth transition with state and federal regulators who will be drafting the required regulations.
When will these new reforms become effective?
In 2014 - Individuals and small businesses will be able to purchase coverage through state-based exchanges. Consumers will be able to purchase health insurance regardless of health status and premiums cannot vary because of health status. Individuals will be required to purchase health insurance or pay a penalty. Subsidies will be available on a sliding scale to help individuals or families with incomes up to 400 percent of the federal poverty level to purchase insurance through new state-based exchanges.
Will insurers have to cover everyone regardless of their health status?
Yes. Blue Cross and Blue Shield companies have long supported guaranteeing that everyone could purchase health insurance coverage regardless of their health condition coupled with a requirement for everyone to obtain and maintain coverage. Beginning in 2014, the new law requires that all individuals have coverage and insurers must offer coverage to anyone regardless of health status and cannot vary premiums based on health status.
How will health reform affect my premiums?
There are a number of factors that are driving health insurance premiums. Increasing utilization attributable to an aging population, obesity and chronic illnesses; new treatments; prescription drugs and expensive new technologies are the biggest causes of increasing healthcare premiums. The new law establishes a few pilot programs, but does not aggressively attempt to control rising healthcare costs.
We believe that premiums will increase as a result of provisions in the reform legislation that will guarantee richer levels of benefits than most consumers who obtain their own insurance purchase today. Insufficient discounts for the young and healthy will encourage many of them to forgo coverage. New fees and taxes mandated by the new law will also likely increase the cost of premiums as they are phased in.
Blue Cross and Blue Shield companies will continue to work with doctors, hospitals, employers and consumers to rein-in costs and insurance premiums while improving access to quality healthcare. In doing this, many of the Blue Cross and Blue Shield companies have initiatives to reduce unnecessary hospital readmissions, eliminate infections acquired during hospital visits and promote paying doctors and hospitals for quality outcomes to help achieve this goal.
I am currently uninsured. How will I obtain coverage in the future?
Many Blue Cross and Blue Shield companies already offer low-cost health insurance options that you may be able to enroll in today. You can find coverage options through your local Blue Cross and Blue Shield company.
Beginning in 2014, state health insurance exchanges will enable consumers to compare benefits, prices and networks of providers and purchase coverage.
Prior to the establishment of state exchanges in 2014, a temporary high risk pool program will be created by the federal government to provide coverage to high-risk individuals who have not been covered during the prior 6-month period or do not have access to coverage, to purchase coverage. A majority of states already have high-risk pools for their residents.
I am graduating from college this year. Will I be able to obtain coverage under my parents’ health plan?
As of Sept. 23, 2010, the law allows dependents up to age 26 to obtain coverage under their parents’ plans that offer dependent coverage. In April 2010, the 38 independent Blue Cross and Blue Shield companies offered to voluntarily extend coverage in their group and individually insured health plans to allow young adults to remain on their parents’ policies.
What if I can't afford to purchase coverage?
Blue Cross and Blue Shield companies offer many different options, including many that are much more affordable than many people realize. Talk with your local Blue Cross and Blue Shield company about options that could fit your needs. AskBlue or use our guide to find health care coverage options near you. Consumers who purchase coverage on their own may qualify for federal subsidies to help offset higher premiums beginning in 2014. Federal agencies must work out how subsidies would be paid. The Congressional Budget Office estimates that about 20 million American households will be eligible for subsidies. In addition, eligibility in Medicaid, the federal-state program that provides health coverage to millions of Americans, will expand to cover families with incomes up to 133 percent of the federal poverty level.
If you are looking to purchase individual health insurance coverage, enter your ZIP code here: AskBlue.