Experts give answers about the new health-care law

Gerard Anderson and Bradley Herring of the Johns Hopkins Bloomberg School of Public Health answer questions about the new health-care law. Anderson is director of the school's Center for Hospital Finance and Management; Herring directs its PhD program in health economics and policy. Send further questions to Anderson and Herring at health-science@washpost.com.

Of all the changes that are coming, are there any that start very soon? What should consumers be prepared to take advantage of?

Herring: While the major provisions of the health-care law take effect in 2014, many begin within a year. One set of provisions affects people with preexisting conditions: Within six months, a national high-risk pool will be available for those denied coverage. Also, insurers won't be able to consider a child's health condition when selling a plan, impose lifetime limits on benefits, or rescind a policy for reasons other than fraud.

A second set of provisions expands access to group coverage: Beginning immediately, low-wage small businesses can receive tax credits to offset the costs of coverage. And adult children under 26 will soon be able to remain on a parent's plan. (See below.)

A third set of provisions affects Medicare beneficiaries reaching the "doughnut hole" in drug coverage: In 2010, they'll receive a $250 rebate, and in 2011 they'll get a 50 percent discount on drug prices.

My unemployed son turns 23 this month; can I put him on my insurance now? If not, can I reinstate him whenever the law kicks in?

Anderson: The provision that allows you to enroll your son in your health insurance takes effect on Sept. 23, 2010; you can reinstate him then. This provision should benefit approximately 4.7 million uninsured young adults. However, many of the large health insurers have decided to allow uninsured young adults to be enrolled on their parent's health plan before Sept. 23. For a list of these plans, go to the White House Office of Health Reform Web site and look under tax treatment for young adults.

Herring: Many employers' benefits, including the Federal Employees Health Benefit Plan, aren't likely to formally change until the first subsequent open enrollment period, which is commonly Jan. 1. As a result of the new federal law, your son will remain eligible for your policy until he turns 26. If he is still not working, or he's not at a job offering insurance, when he turns 26 in spring 2013, he'll have to wait until January 2014 to be offered subsidized health insurance coverage through a newly formed health insurance exchange or the Medicaid program.

At this time, we all know that big insurance companies bargain down the price of certain medical tests and procedures: A test with a supposed charge of, say, $800 will only cost an insurance company $500. Does that change under the new law?

Anderson: Most insurance companies negotiate with hospitals and other health-care providers to get lower rates. Unfortunately, the uninsured typically do not have the ability to negotiate with health-care providers and must pay the full charges. However, as more Americans obtain health insurance, there will be fewer uninsured Americans paying full charges. There are also provisions in the law that create additional incentives for health insurers to negotiate more aggressively with providers to hold down health-care prices.