Making Health Care More Affordable

For decades, rising health care costs have hurt American competitiveness, and forced too many families into bankruptcy to get their families the care they need. That’s why, after years of inaction in Washington, President Obama took on the insurance companies to pass comprehensive health insurance reform, giving Americans the security of knowing that insurance companies will be required to cover preventive care, won’t be able to deny them coverage for a pre-existing condition, can’t drop them if they get sick, and won’t be able to bill them into bankruptcy because of an illness or injury.

The Affordable Care Act, passed by Congress and signed into law by President Obama in March 2010, gives middle class families better health security by putting in place comprehensive health insurance reforms that will hold insurance companies accountable, lower health care costs, guarantee more choice, and enhance the quality of care for all Americans.

Here are some of the most important ways health care reform will benefit middle class Americans, several of which are already in place:

Ending insurance industry abuses: The Patient’s Bill of Rights puts consumers, not insurance companies, in control of their health care. Insurance companies can no longer deny coverage to children with existing conditions, cancel coverage when people get sick, and place lifetime dollar limits on the amount of care you can get.

Giving parents peace of mind: Young adults can remain on their parent’s plan until their 26th birthday. Since taking effect in September 2010, over 1 million young adults have gained coverage through this provision of the new law. For more information on how to take advantage, visit www.facebook.com/YoungAdultCoverage.

Expanding coverage for women: In July 2011, the U.S. Department of Health and Human Services announced historic new guidelines that will help meet women’s health needs. Beginning August 1, 2012, women’s preventive services will be covered with no cost sharing in new health plans. These additional services include, among others, well-woman visits, gestational diabetes screening, breastfeeding support, domestic violence screening, contraception, HPV DNA testing, and HIV screening and counseling. These preventive services help women stay healthy, and because they enhance long-term detection and treatment, they also reduce long-term health costs.

Coverage for those who need it most: Uninsured people with a pre-existing condition now have a guaranteed, affordable health insurance option. The Pre-Existing Condition Insurance Plan (PCIP) provides coverage until 2014, when you will have access to affordable health insurance choices through an Exchange, and you can no longer be discriminated against based on a pre-existing condition.

Sticking Up for Seniors: The law ensures that we continue to protect seniors’ guaranteed Medicare benefits while taking important steps to fight waste, fraud, and abuse. The new law will close the prescription drug coverage gap known as the “donut hole” completely by 2020. In 2010, 4 million people with Medicare who fell into the “donut hole” received $250 rebate checks. In 2011, people with Medicare in the donut hole receive a 50 percent discount on their covered brand name prescription drugs. In addition, people with Medicare are now eligible for an annual wellness visit and free preventive services, such as mammograms and colonoscopies.

Helping small business protect their workers: Small businesses may be eligible for tax credits, making it easier for them to provide coverage to their workers. Small businesses can learn more about their health insurance options via the Insurance Finder on HealthCare.gov. In 2014, the amount of the tax credit will increase and a new health care marketplace will ensure American businesses can offer quality, affordable health care coverage options.

Easy to understand your options: Starting in March 2012, consumers will have an important new tool to understand their coverage. Health insurers and employers who offer coverage to their workers must provide clear and consistent information about your health plan – similar to the kind of nutritional information you find on the food you buy at the grocery store. Specifically, you will have access to an easy to understand Summary of Benefits and Coverage, which will include basic information that every person should have, including: What is my annual premium? What is my annual deductible? What services are NOT covered by my policy? What will my costs be if I go to a provider in my network versus one that is not in my network? Coverage examples will illustrate what you pay in certain circumstances.

Ending coverage limits: Before health care reform, cancer patients and individuals suffering from other serious and chronic diseases were often forced to limit or go without treatment because of an insurer’s lifetime limit on their coverage. For new plans beginning September 23, 2010, insurance companies can no longer put a lifetime limit on the amount that they will pay for enrollees, so families can live with the security of knowing that their coverage will be there when they need it most. Annual limits on coverage are phasing out over the next three years so that, beginning in 2014, insurance companies will no longer be able to impose annual dollar limits on coverage either.

Putting Patients First: New regulations require health insurers to spend 80 to 85 percent of consumers’ premiums on direct care for patients and efforts to improve care quality. This regulation, known as the “medical loss ratio” provision of the Affordable Care Act, will make the insurance marketplace more transparent and make it easier for consumers to purchase plans that provide better value for their money. Proposed premium increases of 10 percent or more will also be subject to new scrutiny.