Major ways the overhaul will affect those (ex-pats) who currently have health insurance and those who do not -- whether insured in the USA or elsewhere.

http://www.nytimes.com/interactive/2010/03...html?ref=policy

Another interesting note is whether health insurance packages issued in Thailand or otherwise ex-USA will comply for those required to purchase insurance (i.e. less than 330 days each year outside USA) as defined as ESSENTIAL BENEFITS PACKAGE in HR 4872 Sec. 122

BUPA Thailand e.g. does not have co-payments or annual / lifetime limits only per incident limits which is OK; outpatient coverage would be required; required coverages such as 'substance abuse', or 'rehabilitative' and 'preventive' services might make this dodgy.

I don't think non-US based insurance will meet the insurance requirements (in 2014).

I have never read in the HR 3962 or the final HR 4872 version that the insurance required in 2014 and thereafter must be purchased within 50 states and or US territories.

As I mentioned in the political topic elsewhere on TV.com, I will hit Medicare age not too many years after 2014 and can always arrange for those few intervening years to remain outside the USA for more than 330 days per year.

I had heard they had decided no non-US insurance would qualify and when it was reported in the news, it sounded like a final decision to me. I also don't know where that is in the bill.

HR 4872 -- SEC. 401. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.

(d) ACCEPTABLE COVERAGE REQUIREMENT.—

(1) IN GENERAL.—The requirements of this subsection are met with respect to any individual for any period if such individual (and each qualifying child of such individual) is covered by acceptable coverage at all times during such period.

(B ) GRANDFATHERED HEALTH INSURANCE COVERAGE; COVERAGE UNDER GRAND-FATHERED EMPLOYMENT-BASED HEALTH

PLAN.—Coverage under a grandfathered health insurance coverage (as defined in subsection (a) of section 102 of the America’s Affordable Health Choices Act of 2009) or under a current employment-based health plan (within the meaning of subsection (b ) of such section).

(G) OTHER COVERAGE.—Such other health benefits coverage as the Secretary, in coordination with the Health Choices Commissioner, recognizes for purposes of this sub section.

from AAHC 2009:

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘grandfathered health insurance coverage’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met -- (conditions then follow)

from PUBLIC HEALTH SERVICE

(2)

Health insurance issuer

The term

“health insurance issuer”

means an insurance company, insurance service, or insurance organization (including a health maintenance organization, as defined in paragraph (3)) which is licensed to engage in the business of insurance

in a State

and which is

subject to State law

which regulates insurance (within the meaning of section 514(b )(2) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1144 (b )(2)]). Such term does not include a group health plan.

So maybe the only way to have an approved plan issued by someone such as BUPA is under that catch-all 'G' as above... so I guess it may be the 330 days ex-USA route for me for a few years until Medicare kicks in.