HEALTH CARE ACT
Immediate Benefits for
Small business tax credits. 15,700 small businesses
in Rhode Island could be helped by a new small business tax
credit that makes it easier for businesses to provide coverage
to their workers and makes premiums more affordable.1 Small
businesses pay, on average, 18 percent more than large businesses
for the same coverage, and health insurance premiums have
gone up three times faster than wages in the past 10 years.
This tax credit is just the first step towards bringing those
costs down and making coverage affordable for small businesses.
Closing the Medicare Part D donut hole. Last
year, roughly 15,100 Medicare beneficiaries in Rhode Island
hit the donut hole, or gap in Medicare Part D drug coverage,
and received no extra help to defray the cost of their prescription
drugs.2 Medicare beneficiaries in Rhode Island who hit the
gap this year will automatically be mailed a one-time $250
rebate check. These checks will begin to be mailed to beneficiaries
in mid-June and will be mailed monthly throughout the year
as new beneficiaries hit the donut hole. The new law continues
to provide additional discounts for seniors on Medicare in
the years ahead and completely closes the donut hole by 2020.
Support for health coverage for early retirees.
An estimated 11,600 people from Rhode Island retired before
they were eligible for Medicare and have health coverage through
their former employers. Unfortunately, the number of firms
that provide health coverage to their retirees has decreased
over time.3 Beginning June 1, 2010, a $5 billion temporary
early retiree reinsurance program will help stabilize early
retiree coverage and help ensure that firms continue to provide
health coverage to their early retirees. Companies, unions,
and state and local governments are eligible for these benefits.
New consumer protections in the insurance
market beginning on or after September 23, 2010.
Insurance companies will no longer be able
to place lifetime limits on the coverage they provide, ensuring
that the 606,000 Rhode Island residents with private insurance
coverage never have to worry about their coverage running
out and facing catastrophic out-of-pocket costs.
Insurance companies will be banned from dropping
people from coverage when they get sick, protecting the 52,000
individuals who purchase insurance in the individual market
from dishonest insurance practices.
Insurance companies will not be able to exclude
children from coverage because of a pre-existing condition,
giving parents across Rhode Island peace of mind.
Insurance plans use of annual limits
will be tightly regulated to ensure access to needed care.
This will protect the 554,000 residents of Rhode Island with
health insurance from their employer, along with anyone who
signs up with a new insurance plan in Rhode Island.
Health insurers offering new plans will have
to develop an appeals process to make it easy for enrollees
to dispute the denial of a medical claim.
Patients choice of doctors will be protected
by allowing plan members in new plans to pick any participating
primary care provider, prohibiting insurers from requiring
prior authorization before a woman sees an ob-gyn, and ensuring
access to emergency care.
Extending coverage to young adults. Beginning
on or after September 23, 2010, plans and issuers that offer
coverage to children on their parents policy must allow
children to remain on their parents policy until they
turn 26, unless the adult child has another offer of job-based
coverage in some cases. This provision will bring relief to
roughly 3,590 individuals in Rhode Island who could now have
quality affordable coverage through their parents.4 Some employers
and the vast majority of insurers have agreed to cover adult
Affordable insurance for uninsured with pre-existing
conditions. $13.5 million federal dollars are available to
Rhode Island starting July 1 to provide coverage for uninsured
residents with pre-existing medical conditions through a new
transitional high-risk pool program, funded entirely by the
Federal government. The program is a bridge to 2014 when Americans
will have access to affordable coverage options in the new
health insurance exchanges and insurance companies will be
prohibited from denying coverage to Americans with pre-existing
conditions. If states choose not to run the program, the Federal
government will administer the program for those residents.
Strengthening community health centers. Beginning
October 1, 2010, increased funding for Community Health Centers
will help nearly double the number of patients seen by the
centers over the next five years. The funding could not only
help the 48 Community Health Centers in Rhode Island but also
support the construction of new centers.
More doctors where people need them. Beginning
October 1, 2010, the Act will provide funding for the National
Health Service Corps ($1.5 billion over five years) for scholarships
and loan repayments for doctors, nurses and other health care
providers who work in areas with a shortage of health professionals.
This will help the 6% of Rhode Islands population who
live in an underserved area.
New Medicaid options for states. For the first
time, Rhode Island has the option of Federal Medicaid funding
for coverage for all low-income populations, irrespective
of age, disability, or family status.
1 Center for Financing, Access and Cost Trends,
2 Office of the Actuary. Centers for Medicare and Medicaid Services.
3 Kaiser Family Foundation. 2009 Employer Health Benefits Survey.
4 U.S. Census Bureau, Current Population Survey. Annual Social