As Republican lawmakers continue their push to repeal and replace the Patient Protection and Affordable Care Act, an HHS official highlighted two health coverage plans in the law designed to help Americans who are early retirees or who have pre-existing conditions.
HHS official highlights benefits of two coverage plans in reform law
The Affordable Care Act's Early Retiree Reinsurance Program, or EERP, reimburses participating employment-based plans for a portion of the costs of health benefits for early retirees and their spouses, surviving spouses and dependents, according to Richard Popper, the director of insurance programs at HHS' Office of Consumer Information and Insurance Oversight.
Available until 2014—when more comprehensive health insurance changes take effect—the program reimburses 80% of claims costs for each early retiree (or their family) between $15,000 and $90,000 during a plan year. Last year's health reform law allocated $5 billion for this program, and eligible sponsors include employers, unions, state and local governments, and religious organizations that offer employment-based health benefit plans to early retirees and their dependents. Eligible early retirees are those 55 and older who are not eligible for Medicare coverage; are not active employees of the organization sponsoring or contributing to the plan; and are enrolled for health benefits in a certified employment-based plan.
In a panel discussion sponsored by the Alliance for Health Reform, Popper said the program requires sponsors to use reimbursements only to reduce their health benefit premiums or health benefit costs; reduce health benefit premium contributions, co-payments, deductibles, coinsurance or other out-of-pocket costs for plan participants; or a combination of these. Of the 6,500 sponsors who have submitted applications, more than 5,000 have been approved, Popper said. When asked how much of the funding has been allocated—and what's the most that has been reimbursed to date—Popper said those figures will be available next month in the president's budget.
Joseph Antos, who specializes in healthcare and retirement policy at the conservative American Enterprise Institute, questioned the fundamental use of this program if it is only to last for a few years.
The other program Popper described is the Pre-existing Condition Insurance Plan, which provides immediate coverage for individuals who have been uninsured for a minimum of six months prior to applying for the PCIP, who have a pre-existing condition, or who have been denied coverage because of a health condition.
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