Friday, February 11, 2011

Impact of Health Care Spending Caps

While Congress debates repealing the federal health care law or changing specific provisions such as mandatory health insurance and prohibiting denial of coverage for those with preexisting conditions, Families USA says one low-profile provision will protect Pennsylvania families from catastrophic medical expenses.
That provision puts a cap on out of pocket costs for insured people for co-payments, deductibles and treatments not covered. The spending caps take effect in 2014 like many other features of the health care law. Starting in 3 years, those caps will be $5,950 for an individual per year and
$11,900 for a family.
Ron Pollock, executive director of Families USA, says this year alone 452,000 Pennsylvanians will spend an estimated $655 million beyond the out-of-pocket caps.......

"This is going to provide a significant protection that does no exists and that will enable people to save money for other necessities."

Pollock says their study shows that nearly 40% of Pennsylvanians who will spend more than the caps are in families where the head of the household works for a small business...
"These caps will be of special value to small businesses and the employees of small businesses."
He says that's because rising health insurance costs have pressured small business owners into passing off the increases to workers through higher deductibles and co-payments.

Pollock says their study shows that there is still a great deal of confusion about the federal health care legislation because "it's a big law with many features."

He says they are not releasing this study as a preemptive strategy to head off a possible elimination of the 2014 caps...."I don't thing that this provision is under attack. I have not heard yet that anyone is really interested in eliminating, or reducing, or changing the caps."

He says there are features of the law that have engendered more controversy. He adds there are many provisions that are not controversial and therefore have not gotten much attention, and that's the purpose of this report on the out-of-pocket caps.

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