The Patient Protection and Affordability Care Act (“PPACA”), passed March 23, 2010, includes multiple new laws affecting the provision of services at campus health centers. While not fully effective until January 1, 2014, some parts of the law became effective September 23, 2010.

  • Extension of Dependant Coverage Until Age 26 (Title I, Subtitle A, Section 2714) – see HHS Review
    • Effective September 23, 2010, PPACA requires plans and issuers that offer dependent coverage to make the coverage available until a child reaches the age of 26
  • Expanded Medicaid Eligibility (Title II, Subtitle A, Sec. 2001) – see summary memo
    • Effective January 1, 2014, Medicaid is set to expand its eligibility for coverage to include persons with income levels at or below 133 percent of the federal poverty level
    • Lower income students become Medicaid eligible, with no co-pays or deductibles
  • Required Coverage for Preventative Health Services, Including Immunizations (Title I, Subtitle A, Section 2713) – see HHS summary
    • Effective September 23, 2010
    • The Regulations specifically state that “a plan or issuer is not required to provide coverage for recommended preventive services delivered by an out-of-network provider.”
  • Restricted Annual Dollar Limits on Coverage (Title I, Subtitle A, Section 2711) –see Patient Bill of Rights
    • Effective September 23, 2010
    • No lifetime limits
    • Annual caps cannot be lower than $750,000 for plans issued after 9/23/10; this cap increases to $1.25mm in 2011, $2.0mm in 2012, and is eliminated in 2014.
  • Increased Consumer Choice – new state exchanges (Title I, Subtitle D, Section 1312)
    • Effective January 1, 2014
    • Students can purchase insurance on a state exchange
  • The information above is presented not to make a judgment about the politics of PPACA, but to provide you with knowledge of specific provisions that may affect you and your student. I hope that you find it helpful.

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