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| | Health insurance companies will be required to spend on medical care at least 80% of the premium payments they receive from individual and small-group plans (and at least 85% from large group plans). The federal government will define what constitutes medical care. | | Health insurance companies will be required to spend on medical care at least 80% of the premium payments they receive from individual and small-group plans (and at least 85% from large group plans). The federal government will define what constitutes medical care. |
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| | + | === Immediate Impact in 2010 === |
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| | + | Creating temporary high-risk pool with subsidized premiums for certain people with pre-existing conditions |
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| | + | Imposing new taxes on some facilities, such as tanning parlors |
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| | + | === Requirements for Insurance Companies === |
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| | + | Prohibit bans on pre-existing health conditions in children, lifetime and annual limits on expenses, and limits coverage exclusions of pre-existing health conditions in adults |
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| | + | Requires family policies to include children up to age 26 |
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| | + | Does allow states to form compacts in order to allow the interstate sale of insurance |
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| | + | Requires direct access to obstetrical and gynecological care, which might include [[abortion]] |
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| | + | Creates (by 2014) health insurance exchanges or marketplaces that will be state-based and state-administered, but states can opt out of this if certain conditions are met; insurance can be sold within the exchange only if government-approved, but insurance can be sold outside of the exchange |
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| | + | Prohibits health plans from discriminating against providers, but plans are not required to contract with any provider |
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| | + | Requires health plans to develop politically correct language services, community outreach and cultural competency trainings |
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| | + | === Employer Requirements === |
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| | + | Requires employers having more than 50 full-time employees must provide health insurance or pay a penalty. |
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| | + | Empolyees having 25 or less full-time employees and average salaries of $50,000 or less can apply for tax credits to provide health insurance to their employees. |
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| | + | === Medicaid === |
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| | + | ObamaCare expands Medicaid (medical care for the poor) to everyone (under the Medicare age of 65) who has income less than 133% the federal poverty level. States must pay this enormous new burden, but federal government promises to reimburse costs of newly eligible patients under this program from 2014 to 2016. |
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| | + | === New Bureaucracy === |
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| | + | Establishes a new Consumer Operated and Oriented Plan (CO-OP) program with the goal of creating non-profit, member-run health insurance companies in every state |
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| | == Basis for Legal Challenges == | | == Basis for Legal Challenges == |