Monday, September 3, 2012

Because Your Doctor Cares: What You Need to Know About Health Care Reform

During the health care debate, doctors worked to make sure nothing would come between you and your doctor. Now that Supreme Court has upheld most of the law, that is still our biggest priority.

The goal of health reform was to lower health care costs and cover millions of Americans with insurance. Your doctors are working to make sure that doesn't mean you get lower quality of care or less care.

We know health reform is big and confusing. Some parts of the law started in 2010. Other parts are rolling out over the next eight years. Texas physicians have carefully studied the law to help you understand what the changes mean to your health care.

What You Need to Know About Health Reform.
  • Most people must have health insurance beginning in 2014 or face a tax penalty.
  • People who cannot get affordable health coverage from their employer can buy it through a federal or state health insurance exchange. Starting in 2014, some people can get tax credits to reduce the cost of their premiums, copays, and deductibles.
  • Small businesses also can buy health coverage through an exchange.
  • Large employers (50-plus employees) who don't offer health coverage to their employees must pay a penalty for each employee who receives a tax credit to buy their health insurance through an exchange.
  • Health insurance companies must provide coverage to anyone, regardless of health status or a preexisting condition. People will not pay more because of their health status or sex.
  • There will be no lifetime or annual dollar limits on health insurance coverage.
  • Texas has an option to use federal funding to expand the Medicaid program to cover more low-income adults.

Here are a few questions Texas patients have asked their doctors. There are many more. Please feel free to submit your questions to Me&MyDoctor.

The Big Questions

Q. Will I still be able to see my current doctor?

A: Generally, yes. However, your doctor may or may not continue to participate in your health plan or in Medicare or Medicaid. Talk to your doctor.

Q. Will I still be able to get the care I need?

A: There is no simple answer to that. Much of what is in the new law has never been tried before. We (your doctors) pledge our best to make sure our patients get the care they need.

Q. How much will this cost me?

A: Again, there’s no simple answer. People who choose not to buy health insurance will be taxed. The law also may shift costs from older, sicker people to younger, healthier ones. How much you pay for health care will depend on the type of health plan you have, amount of the deductible and copay, and whether you qualify for a subsidy, Medicare, or Medicaid.

The good news is preventive services, like vaccines and screening tests, will be fully covered. People on Medicare will find more of their prescription costs covered, too.

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