As Good as Congress’
Many Americans will get the same deal as members of Congress. The new law requires these legislators to buy coverage through state insurance xchanges that start in 2014. The exchang- es— mainly for those who don’t have mployer insurance– will offer options closely resembling those that all federal workers have today as this chart shows:
Federal
Employees
Health Benefits
Program
Many private plans of all
types, available through
a national exchange run
by federal government,
Vary according to plan,
with specific minimum
benefit package
No
No
No
Yes, up to 75%
of premiums
Coverage
Provisions
Choice of
insurance plans
Benefits
Can insurers deny cover-
age or charge higher rates
based on health status or
preexisting conditions?
Can insurers charge higher
rates based on age?
Can insurers charge higher
rates based on gender?
Government subsidies
The New
Health Care
Reform
Law
Many private plans of all
types, available through
state-run insurance
exchanges, for individuals
and families without
employer or public coverage
Vary according to plan,
with specific minimum
benefit package
No
Yes, up to a limit
No
Yes, reduced premiums
for enrollees with incomes
below a certain level
Yes
Annual out-of-pocket
expense maximum
Yes
Yes, through age 21
Coverage for
dependent children
Yes, through age 25
Yes
Year-round prescription
drug coverage
Yes, and also narrows
and finally eliminates
Medicare Part D
“doughnut hole” by 2020
Yes
Plans required to meet
certain standards to
participate in program
Yes
Yes
Plan details posted online
so consumers can compare
costs and benefits before
enrolling
Yes
Yes
Enrollees allowed to
switch plans each year
Yes
This special report was produced by the AARP Bulletin.
For the latest news on health care reform, go to bulletin.aarp.org/health_care.
Copyright © 2010 by AARP.
All rights reserved.
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