Affordable Care Act: What's in the fine print?

As we celebrate the one year anniversary of the passage of health care reforms, ConsumersUnion®, the non-profit publisher of Consumer Reports, has detailed the "fine print" in the Patient Protection and Affordable Care Act.

Referring to the health care debate, CU President and CEO Jim Guest said, "...you need to know about the benefits—and when they become active—to actually take advantage of them."

That said, you need to look at the negatives which mostly hinge on the fact that states could trump the new law's provisions. "States are responsible for reviewing health insurance rate increases. But many states don’t closely examine an increase to make sure it is justified."

Here are some points to pay close attention to regarding insurance plans under the new Act, according to the report.

• Some plans received temporary waivers delaying the requirement that they end annual benefit limits. Ending lifetime and annual limits applies only to “essential” health benefits as determined by the federal government.

• Insurers can still cancel your policy for fraud or intentional misrepresentation.

• New rights of appeal, free preventive care, and phased out annual limits don’t apply to many grandfathered plans.

• Until 2014, insurers can still charge higher premiums for sick children, so insurance for them may not be affordable. State laws may restrict access to new coverage for sick kids to specific open-enrollment periods. Insurers in some states have threatened to stop selling child-only policies.

• Your costs will vary by state, but all options include comprehensive coverage with no out-of-pocket costs for preventive care.

• Premiums are not based on income, so a PCIP may still be unaffordable for some, and premiums for small-business owners and their families do not qualify for the tax credit. Tax credits vary for small businesses.

• Some states where insurers have very high administrative costs may ask for the new standard to be phased in. Check with your state insurance department to find out if your state has been granted a waiver.

• Employers and insurers that offer policies with very limited coverage may be given at least an extra year before being subject to this rule.

For more information, go to: http://www.consumerreports.org/health/resources/pdf/ncqa/health-reform.pdf.