HHS is working to implement provisions of the Affordable Care Act to secure and expand access to affordable health insurance coverage and strengthen consumer protections in health insurance. These reforms put Americans back in charge of their own health care by creating an important foundation of patients’ rights in the private health insurance market and increasing health coverage choices for families.
- Make Coverage More Secure for Those Who Have Insurance
HHS is making coverage more stable and secure through insurance market reforms. Thanks to the Affordable Care Act, children cannot be excluded from coverage based on their pre-existing health conditions, and in 2014 that protection will be extended to all Americans. Insurers are now prohibited from putting lifetime dollar limits in health plans, which could often leave people without medical care when it is most needed. HHS is working with states to identify unreasonable rate increases by health insurance plans, and is requiring new health plans to implement an appeals process for coverage or payment decisions. Additionally, health insurers are generally required to spend 80 or 85 percent of health insurance premiums on medical care and quality improvement, not on profits and overhead.
- Expand Consumer Choice and Support Informed Decision-Making
HHS is expanding consumer choice and supporting informed decision-making about health insurance coverage. HealthCare.gov, a new website developed by HHS,provides unprecedented access to critical information about private insurance plans and available public programs, enabling consumers to compare options. HHS is helping states to develop new, competitive private health insurance markets called Affordable Insurance Exchanges that will allow millions of Americans and small businesses to compare a range of plans and buy insurance at affordable prices beginning in 2014. New premium tax credits and cost-sharing reductions will help ensure coverage is affordable for families. Through the Exchanges, individuals and small businesses will have the same choices of health insurance as members of Congress. The Exchanges will guarantee that all people have a choice of quality, affordable health insurance even in the event of a job loss, job switch, move, or illness.
- Make Health Insurance Coverage More Affordable and Accessible
HHS is establishing new programs that make health insurance coverage more affordable and accessible. As a bridge to 2014, the Early Retiree Reinsurance Programhelps employers continue to provide much-needed health insurance to their retirees age 55 to 64 who are not yet eligible for Medicare. This program is helping both retirees, who will no longer be faced with potentially financially devastating health care costs, and employers, who will be able to continue to provide affordable health care coverage to retirees. The Pre-Existing Condition Insurance Plan program provides comprehensive insurance for Americans who have been uninsured for six months and have a pre-existing condition.
- Increase Health Insurance Coverage for Low-Income Populations
HHS is working to extend Medicaid coverage to millions of low-income individuals who were previously not eligible for coverage. By simplifying complex eligibility rules and systems for processing most Medicaid applications, HHS is establishing a streamlined system of coverage that will seamlessly and efficiently meet consumers’ needs, improve quality, and lower costs.