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How Will Healthcare Reform Benefit The Uninsured?

2010

  • High-risk pools: The health reform law creates a temporary high-risk pool that provides immediate access to insurance for any South Carolinian with a pre-existing condition who has been uninsured for least 6 months. The new high-risk pool begins in July.
  • South Carolina is not running its own high rist pool.  If you have been uninsured for the past six months you can enroll through www.healthcare.gov
  • Increased funding for Community Health Centers (CHC), which provide free or low-cost, sliding-fee scale services. Increasing the number of the CHC’s means increase in access and affordability of care, especially in rural areas.
  • Adult children (up to age 26) will be able to stay on parents insurance, with parents permission and provided that they don’t have access to employer sponsored coverage
  • Children with pre-existing conditions can no longer be denied coverage by insurers
  • Uninsured patients protected by new nonprofit hospital standards:

o Written financial assistance policies clearly stating eligibility guidelines & how to apply
o Protections from being overcharged
o Prohibits extraordinary collection actions against patients

2014

  • Adults with pre-existing conditions can no longer be denied affordable insurance
  • Individuals buy insurance through a new online, state-based marketplace called an exchange
  • Individuals and families may receive subsidies to help buy coverage from the health insurance exchange. Based on your income, there will be a cap to the amount you will be charged for premiums and your out-of-pocket expenses will also be capped
  • Medicaid will expand to all adults and children with incomes up to 133 percent of the poverty level
  • Those who cannot afford to buy insurance may apply for a hardship waiver; subsidies will be available to Tennesseans with incomes of up to 400 percent of the poverty level
  • If you can afford coverage and choose not to buy it, you will be fined an amount that escalates each year, up to a maximum of $2,085 or 2.5% of household income in 2016
  • Caps on annual benefits are banned