Ohio health insurance reform information is regularly updated on this website (See bottem of page). Ohioquotes.com is the premier trusted resource for up-to-date Ohio health care reform information and affordable Ohio health insurance plans. Instantly, you can read about the most current health insurance reform changes and also view, compare or apply for Ohio health insurance coverage at the guaranteed lowest rate allowable by law.
In March 2010, the US House of Representatives passed H.R. 3590 – The Patient Protection And Affordable Care Act and H.R. 4872 – The HealthCare and Education Reconciliation Act of 2010. Most of the legislation will go into effect in 2014. However, some of the changes will be implemented in 2010 and 2011.
Ohio Health Insurance Reform Changes For 2010
No Exclusion For Children And Coverage Extended to 26th Birthday
In approximately six months, health insurance companies will be prohibited from adding pre-existing exclusion riders to children’s coverage. This will apply to all Ohioans in 2014. Also, young people, up to their 26th birthday, may remain on their parent’s health insurance plan. Currently, many companies require children (that are not full-time students) to obtain separate coverage by age 19.
No Lifetime Maximum
In approximately six months, lifetime limits will be removed from Ohio health insurance plans. This part of the reform package will likely never affect you since individuals and families rarely come close to exceeding their maximum limit.
No Rescission
Health insurance companies will not be able to rescind policies when a person becomes ill. This practice is rarely used.
Temporary High Risk Pool For Ohio Residents
Within 90-120 days, Ohio health insurance reform will utilize a temporary national high-risk pool to provide health insurance to Ohio citizens with pre-existing medical conditions. If uninsured for the last six months, a high-risk pool will be set up that offers subsidized premiums. Presumably, these premiums will be less than the current “Ohio Open Enrollment” rates. You will not be required to pay more than $5,950 for medical expenses (family limit is $11,900).
Indoor Tanning Tax
Starting July 1, there will be a 10% tax on indoor tanning services. And no…I am not making that up!
Preventive And Wellness Benefit Change
New Ohio plans must offer wellness and preventive benefits without copays or deductibles. Currently, most comprehensive plans have small copays but no deductibles on wellness coverage.
Ohio Health Insurance Reform Changes For 2011
Over The Counter Drug Exclusion
Starting in 2011, over-the-counter drugs not prescribed by a physician, will not be eligible for tax-free reimbursement through an HSA, HRA or FSA.
Ohio Health Insurance Reform Changes for 2014
Ohio Health Insurance Exchange
The Ohio health insurance exchange must be created by 2014 and must be administered by a non-profit organization or government agency. The exchange will offer plans that meet stated required guidelines. We do not charge any fees for helping you find a plan in the exchange and the rate we quote for you will be the guaranteed lowest rate allowed by the state.
Change In How Your Rate Is Determined
Pre-existing condition clauses and medical underwriting will no longer be allowed. Ohio health insurance companies will be prohibited from denying coverage or basing rates on any health-related factor such as medical condition, health status or prior claims experience. Premiums will vary by age, smoking status and other factors. However, existing individual plans will not be subject to the new guidelines.
Tax Credits To Pay For Coverage
Tax credits will be given to individuals to help pay their Ohio health insurance premiums. To qualify for the credit, income must be between 100% and 400% of the federal poverty line. For example, a family of four earning less than $88,000 per year would qualify for a partial credit. Lower incomes, of course, would receive larger credits. But you will have to buy a policy to receive the credit.
Get Health Insurance Or Pay A Penalty
Perhaps the most controversial part of health reform is that Individuals must have health insurance coverage or pay a penalty. Starting in 2014 and gradually phased in through 2016, individuals who fail to maintain coverage will be subject to a penalty of $695 per year or 2.5% of income, whichever is higher. Failure to maintain coverage, however, will not result in criminal actions or fines. Penalties seem to be too low and enforcement will have to be modified.
Ohio Health Insurance Exchange Requirements
Any health insurance plan issued through the Ohio health insurance exchange must provide medical benefits that include cost sharing limits. Coverage will be available in four benefit categories: Bronze (60% Coinsurance), Silver (70% Coinsurance), Gold (80% Coinsurance) and Platinum (90% Coinsurance). A lower-cost catastrophic plan must be offered to individuals under 30 and any other individual that is exempt from the insurance requirement.
If you have any questions regarding Ohio health insurance exchanges, health reform, or Ohio health insurance plans, please don’t hesitate to call us at (888) 513 6446. You may also email us at eharris@ohioquotes.com
Helpful Links:
HealthCare Package Timeline
U.S. House Of Representatives Anaylysis
Congressional Budget Office Report
U.S. House Of Representatives Individual Vote Results
UPDATES:
March 31 2010- Although the wording in the bill is vague, the health insurance industry agreed with the section in the health reform law requiring them to provide insurance to children with pre-existing health conditions. This coverage will be provided within six months although rates could be very high.
April 20 2010- Fraud alert! The BBB (Better Business Bureau) is reporting several scams involving people going door-to-door selling phony health insurance plans, referencing health reform and saying you have limited amount of time to take advantage of the new health care. Health insurance is never sold door-to-door, so be careful if you are targeted.
April 21 2010- Wellpoint, the parent company to Anthem Blue Cross, announced as of June 1, it will allow dependents under age 26 to remain on their parent's policies. Even though the new law is not effective until September, Wellpoint is taking steps to prevent a gap in coverage.
May 4 2010- It appears that UnitedHealthCare (Golden Rule in Ohio) will no longer issue "child only" policies. Mysteriously, UnitedHealthCare's Ohio health insurance rating software no longer covers children under age 18 unless they are listed under a parent's policy. As of September, anyone under age 19 can not be denied coverage. It is highly possible that a few other companies may also eliminate "child only" policies.
May 7 2010- The Commisioner of Insurance for the state of Georgia wants no part of the first phase oh health carereform and is questioning the constitutionality of the law. We were able to obtain a copy of the letter he wrote to Kathleen Sebelius. Here it is!
May 7 2010- The "High Risk Pool" for persons unable to qualify for coverage may be ready on July 1. No details on rates and qualifications are still sketchy.
July 7 2010- Under a new law that went into effect on July 1, unmarried Ohio children to age 28 can remain on or be added to their parent's policy. The federal mandate is only to age 26.
July 7 2010- Ohio's new high risk health insurance pool will begin in August. Medical Mutual will operate the pool for Ohio residenrs with major pre-existing conditions such as heart disease and cancer. The program will terminate in 2014 when health insurers will no longer be allowed to deny coverage for health conditions.
July 9 2010- Under health care reform legislation, health insurance policies can be "grandfathered." Anthem provides a nice explanation regarding "grandfathering." Read about it here.
July 27 2010- Guidelines for Ohio Health Insurance Risk Pool are listed below:
Ohioans with pre-existing health conditions, such as cancer or diabetes, can apply for coverage under a new high-risk insurance pool beginning Aug. 1. To qualify, applicants must:
- Provide evidence of a pre-existing condition: written certification by a licensed physician or nurse practitioner, issued within the past six months; or, copy of documents verifying two carriers have refused to issue creditable coverage within the previous six months, or would issue coverage only with an exclusionary rider.
- Have proof of Ohio residency: valid Ohio driver's license, state government ID, payroll stub, Ohio voter registration card, utility bills, rental agreement or Ohio income tax return.
- Have proof of U.S. citizenship, a national of the U.S. or lawfully present in the U.S.: birth certificate, passport or visa.
- Be uninsured for six months prior to the date of applying for coverage.
- Be ineligible for coverage under the Medicare program, the Ohio Medical Assistance Program, the Ohio Children's Health Insurance Program, or an employer-sponsored group health plan, unless subject to a mandatory initial waiting period.
September 3 2010- Ohio’s new insurance pool for those with pre-existing conditions this week and the state announced that 330 Ohioans are currently enrolled (Source: “Ohio health insurance pool covers about 330,” Associated Press via Newark Advocate, Sept. 2, 2010). Of course, more applicants are expected.
As part of national health reform legislation that passed in March, states are required to either set up a special high-risk insurance pool for individuals with pre-existing conditions or enable residents to enroll in a national one. Ohio has contracted with Medical Mutual of Ohio to manage the pool. The state is one of 27 that opted to run its own pool rather than rely on the pool operated by the federal government. Medical Mutual is an old esablished Ohio company with great HSA rates.
September 8 2010- Below are listed some of the changes that become effective on or after September 23 2010:
-Adult Children Coverage to age 26
-Restricted Annual Limits on Essential Benefits (to be defined)
-No Lifetime Limits on Essential Benefits
-No Preexisting Condition Exclusions for Children under 19
-No Rescissions (primarily individual and small group coverage)
-Preventative Services Now Covered
-Revised Appeals Process (non-grandfathered plans only)
-Non-discrimination Rules Extended to Insured Plans (non-grandfathered plans only)
-Emergency Services covered without prior authorization/treated as in-network(non-grandfathered plans only)
-Choice of Providers (pediatrician and OB-GYN) (non-grandfathered plans only)
September 23 2010- Here we are! The six-month anniversery of the health care reform law. Most of the major carriers will offer coverage to children if they are included on their parent's policy. However, "children only" plans are hard to find since the carriers have eliminated those plans.
Cancer screenings are now included in preventive benefits and covered at 100%. Also...Ob-gyn visits do not need a referral inside your Network.
September 30 2010- Additional details released on HSA changes. Beginning January 1, 2011, HSA funds used for a medicine or drug must be prescribed by a doctor or other authorized medical professional. The only exception is insulin. Thus, a bottle of Tylenol, or its generic substitute (which I hope all of you buy) is no longer tax-deductible. This change will NOT have a significant effect on your taxes or HSA account.
November 4 2010- Now in control of the House of Representatives, Republicans are planning to flex their muscles quickly to attempt to repeal Obamacare. But some GOP leaders acknowledge it is unlikely they can get rid of the law right away.
December 14 2010- A federal judge ruled unconstitutional a key provision of President Barack Obama’s sweeping health care overhaul law, moving its mandate that Americans buy health insurance coverage one step closer to a Supreme Court showdown.
U.S. District Judge Henry Hudson, said that Congress had exceeded its constitutional power when it imposed the health insurance mandate. What does this mean? Actually, not too much right now, but it could be the beginning of something more significant. Stay tuned!
January 20 2011- As expected, the House of Representatives voted 245-189 to repeal Obamacare. Three Democrats joined the Republicans in the historic vote. However, the law is likely to remain in place, at least until the next Presidential election in 2012.
April 11 2011- Missouri’s Democratic attorney general is requesting a federal appeals court to overturn Obamacare's requirement for individuals to buy health insurance. Chris Koster, filed a friend-of-the-court briefing asking the 11th Circuit Court of Appeals tooverturn the law’s individual mandate to purchase coverage.
June 23 2011- Whoops. A loophole in the health care reform bill will allow several million middle-class families get subsidized healthcare in 2014 that was meant for the poor. This is beacuse of changes in Medicaid eligibility. Since it would not take affect until 2014, the current administration is looking for options to correct the loophole.
June 27 2011- The Obama administration apparently realizes that there could be a shortage of doctors if Obamacare continues through 2014. So, the government wil be using undercover patients to schedule fictitious appointments with physcians, in order to help determine the difficulty of meeting with an internist. Special thanks to "The New York Times" for this story.
June 29 2011- Well...That didn't last long! The administration ceased the "undercover patient" progam.
June 30 2011- A three-judge panel from the US Court of Appeals in Cincinnati ruled that forcing Americans to purchase health insurance is constitutional. This differs from prior court decisions. In 2014, many Americans will have to buy health care coverage or pay a fine. However, it is likely that the Supreme Court will have the final say on this controversial topic.
July 19 2011- Will there be an "Ohio Health Insurance Exchange" when and if Obamacare is fully operational in 2014? There might be, but it's unclear what it will look like. Gov. Kasich prefers that the state set up this program and not the federal government. And he has good reason. He stated he doesn't want folks in Washington DC to "come in here and run the state.
September 14 2011- Another judge has ruled that the government can not force consumers to purchase health insurance. Pennsylvania Judge Christopher Conner made the decision this week. Undoubtedly, a Supreme Court decision will be needed to sort this all out.
October 2 2011- Individual Ohio health insurance rates could increase by as much as 90-130 percent if Obamacare is fully implemented. This is the opinion of a study completed by an independent consultant hired by Mary Taylor, Director for the Ohio Department Of Insurance.
October 14 2011- The proposed long-term care program has been scrapped. Design flaws and other factors were part of the decision announced today by the Obama administration.
