Health Reform Provisions Kick In

On September 23, a handful of new rules generated by the Affordable Care Act go into effect. They offer several much-needed protections for children, young adults, seniors, and many other patients who struggle to make ends meet – especially if they get sick.

It’s happening just in time – the Census Bureau just released new data on the number of uninsured Americans – 50.7 million in 2009. That’s up from 46.3 million the previous year. In my opinion it is unconscionable that nearly 17 percent of the population cannot get, nor afford, health insurance.

Today, the Republicans said they will do whatever they can to repeal, or at least chip away at the protections that are, or will be provided. They promised to do whatever it takes,  whether it’s withholding funds or targeting specific provisions in the law. Of course this has the full support of the Tea Party.

The argument against health reform is higher premiums and increased costs for employers. That’s valid. But what’s the alternative? Can someone please explain how allowing 50 million citizens to fall through the cracks is upholding the “values” of everyday people? What if it was one of them?

Meantime, circle Thursday on your calendar:

  • Your insurance company cannot charge co-pays, deductibles, or co-insurance for preventive services.  This includes services like mammograms, immunizations, and colonoscopies.
  • If you’re sick, your insurance company cannot cancel coverage because you have reached a lifetime limit or annual cap.
  • Children under age 19 cannot be excluded from coverage because of pre-existing conditions, like asthma, ADD, or diabetes.
  • Referrals are no longer needed to see an obstetrician or pediatrician.
  • Medicare recipients will get some financial relief from the “doughnut” hole stemming from the Part D (prescription) provisions. Co-pays for annual wellness visits and preventive care are eliminated.
  • Young adults are now allowed to stay on their parent’s plan until they turn 26 if their current job does not provide health insurance.
  • Consumers have additional recourse for appeals of coverage determinations or insurance claims and a central review process to streamline and hasten this process.
  • And if you make a tiny technical error on your application, your coverage cannot be dropped if the information was provided “in good faith.” You may recall news reports of typos or minor mistakes on coverage applications, that resulted in Wellpoint and other providers canceling coverage for breast cancer patients mid-course.

If you think these new provisions will help, let your Congressional representatives and Senators know. Make some noise. And if you are lucky enough to have insurance coverage, you’ve be grateful for some additional peace of mind.

Leave a Reply