Update on Affordable Care Act Provisions Effective Now

While no one knows what will happen to national healthcare reform in the coming weeks, the Amherst Chamber of Commerce is committed to keeping you informed on the changes and provisions set to take effect in the coming years. As it stands now, six new healthcare provisions took effect on January 1, 2011. Below is an overview on how they may affect you.

• The Affordable Care Act will benefit seniors in various ways, including closing the "donut hole" that currently exists with Medicare Part D prescription drug coverage. A fifty percent discount will be given to seniors when purchasing Medicare Part D covered brand-name prescription drugs if they have reached their coverage gap. The goal is to have the coverage gap closed by 2020.

• Seniors will also now receive free preventive care services such as annual wellness visits and personalized prevention plans if they are on Medicare.

• Under the new law, the Community Care Transition Program will help recently hospitalized Medicare recipients avoid unnecessary re-admissions by organizing their care and connecting seniors to proper services in the community.

• A fourth provision affecting seniors effective January 1^st established a new Center for Medicare & Medicaid Innovation to begin testing new ways of delivering care to patients. With this, the United States Department of Health and Human Services will submit a national strategy for quality improvement in health care that will overview improving quality of care and reducing the rate of growth in health care costs for Medicare, Medicaid and the Children's Health Insurance Program. 

• A goal of the 2011 provisions is to hold insurance companies accountable. The Affordable Care Act is doing this by now requiring at least 85% of all premium dollars collected by insurance companies for large employer plans to be spent on health care services and quality improvement. For individual and small employer plans, the percentage decreases to 80%. If an insurance company does not fulfill this, they must provide a rebate to their consumers.

• Along with decreasing premiums, a provision effective this year also addresses overpayments to insurance companies. Previously, Medicare Advantage companies were being paid over $1000 more per person on average than is spent per person in Traditional Medicare, leading to increased premiums for all Medicare beneficiaries. With the new law, those enrolled in Medicare Advantage plans will continue to receive all benefits but bonus payments will only be provided to Medicare Advantage plans that provide high quality care.

For a complete timeline of when provisions of the Patient Protection and Affordable Care Act take effect over the coming years, click here.

The Amherst Chamber of Commerce prides itself on providing timely information to our members. We are aware that a repeal of this law will be brought to a vote by Congress in the coming weeks. To receive real-time updates on this issue, contact Christian Solecki at the Chamber at 632-6905.