TAILIEUCHUNG - Private Health Insurance Provisions in PPACA (P.L. 111-148)

The great majority of Wisconsin household residents have health insurance (counting both private and public coverage). In 2008, an estimated 5,045,000 Wisconsin household residents (92%) had health insurance and 433,000 (8%) did not. This estimate is a “snapshot” of Wisconsin at one point in time (Figure 4). (Respondents report on the health insurance coverage of each household member at the time of the survey interview; interviews are conducted from February through December.) The highest proportion insured is among older adults (age 65 and older), among whom nearly 100 percent are insured. Those significantly less likely. | Private Health Insurance Provisions in PPACA . 111-148 Hinda Chaikind Specialist in Health Care Financing Bernadette Fernandez Analyst in Health Care Financing Mark Newsom Analyst in Health Care Financing Chris L. Peterson Specialist in Health Care Financing April 15 2010 Congressional Research Service 7-5700 R40942 CRS Report for Congress------------- Prepared for Members and Committees of Congress Private Health Insurance Provisions in PPACA . 111-148 Summary The Patient Protection and Affordable Care Act . 111-148 PPACA was signed into law on March 23 2010. On March 31 2010 PPACA was amended by . 111-152 the Health Care and Education Reconciliation Act of 2010. This report summarizes the key provisions in PPACA hereafter referring to PPACA as amended by . 111-152 that affect private health insurance. PPACA imposes new requirements on individuals employers and health plans restructures the private health insurance market sets minimum standards for health coverage and provides financial assistance to certain individuals and in some cases small employers. In general PPACA requires individuals beginning in 2014 to maintain health insurance with some exceptions. Individuals will be required to maintain minimum essential coverage which includes eligible employer coverage individual coverage grandfathered plans and federal programs such as Medicare and Medicaid among others. Employers are not explicitly required to provide health benefits although certain employers with more than 50 employees may be required to pay a penalty if either 1 they do not provide insurance under certain circumstances or 2 the insurance they provide does not meet specified requirements. Several insurance market reforms will be implemented including some prior to full implementation in 2014 such as prohibition against lifetime benefit limits and coverage for preexisting health conditions for children. In addition to establishing new federal private health insurance .

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