Glancing at an old New York Times today I had buried in a box beneath my desk, I note a snapshot of Ted Kennedy. I wonder, as the Patient Protection and Affordable Care Act turns six months old today, marking the beginning of a new phase in our country's health history, if Ted would be proud of health reform.
Yes, I think he would. The Act, imperfect though it is, has all the right moves. It improves the status quo, and is a healthy step forward in our march toward fixing years of insurance industry abuse and greed.
After the bruising legislative battle over health reform, featuring misconceptions and outright falsehoods, September 23, 2010 is when rhetoric gives way to reality.
Legislation of this monumental importance and complexity can be difficult to understand in the abstract. So it's no surprise that many Americans have been unsure about what's in the law or how they will gain from the passage of health reform legislation.
Here's a quick snap shot of the reforms that become law today.
1. Bans Insurance Companies from Dropping our Coverage When We Get Sick: In the past, insurance companies could search for an error, or other technical mistake, on a consumer's application and use this error to deny payment for services when he or she got sick. The new law makes this illegal.
2. Prohibits Excluding Coverage for Children With Pre-existing Conditions: Insurance plans can no longer refuse to cover children younger than 19 because they were born with or develop a serious medical condition. (A similar ban on coverage exclusions for adults goes into effect in 2014.)
3. Empowers Consumers to Appeal Insurance Company Denials: The law provides consumers with a way to appeal coverage determinations or claims to their insurance company, and establishes an external review process.
4. Extends Coverage for Young Adults: Young adults can stay on a parent's plan until they turn 26. If you want to put an adult child on your plan, you'll be given an opportunity to do so during a special enrollment period. (This doesn't apply to young adults who already have health insurance through a job.)
5. Provides Free Preventive Care: All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.
6. Eliminates Lifetime Limits on Insurance Coverage: Under the new law, insurance companies will be prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays which, begins putting an end to medical bankruptcies in America.
Here is a good resource to help you follow state implementation efforts from Securities and Insurance Commissioner Monica Lindeen's office [insurance reform, www.sao.mt.gov].
If you have a question, or need advice on any aspect of reform, you can submit a question to Commissioner Lindeen's office.
This is great resource from the White House, and you can always consult with our friends at HCAN.
The American Cancer Society Cancer Action Network also has some great fact sheets (pdf) and time lines (pdf) explaining key health reform benefits for cancer patients.
Quite simply, the health reform bill ends the industry's stranglehold on our access to high quality health care and curtails industry abuses that have made life difficult for millions of Americans and thousands of Montanans for years.
With many of the most important and direct provisions of the law taking effect today, the benefits of ending this stranglehold are clear.
Thanks to health reform, as of today, more Montanans can receive access to the care they need, when they need it. In policies issued from now on, no American will be dropped from their health coverage because they become sick. No child will have insurance coverage denied because they suffer from a pre-existing condition, and children who do not have insurance through a job can stay on their parents' health insurance until age 26.
From today forward, lifetime caps on coverage become part of the past, annual limits on coverage are severely restricted, and eligibility for employer health plans will not be based on how much money you make. And, recognizing that preventing people from becoming sick in the first place saves money and saves lives, the law also ensures that private insurance plans cover preventive health services, such as screening and health counseling, without requiring co-pays or triggering deductibles.
We will finally start reaping the rewards of a health care system that works for everyone.
It's a good thing for all of us that health reform is here to stay. The new law isn't perfect, but it's a dramatic improvement over the current broken system. Provisions in the law that take effect today give Americans more access to the care they need, crack down on insurance company abuses, replace insecurity with new measures of stability for millions of young people, and promise to improve our peace of mind along with their health. |
