Health Care for America Now - Update

September 22, 2010

September 23rd, Major Provisions of the Affordable Care Act Kick In

As of September 23rd, major provisions of the Affordable Care Act kick in including, consumer protections that end the worst of insurance company abuses. The new law puts an end to odious practices like dropping people because they got sick, putting annual and lifetime limits on how much coverage you can get from the insurance policy you rightly thought covered everything, and denying children coverage because they're sick.

Once the law is fully implemented, insurance companies will not be able to deny any of us coverage because we have an illness, or drop us when we do, or force us into bankruptcy because of caps on how much of our health care they'll pay for.

  1. 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.)
  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. 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.
  4. 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.
  5. 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.
  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 and end to medical bankruptcies in America.
  7. Tax credits for small businesses providing coverage to workers: Already in effect, qualified small businesses get tax credit for up to 35% of their premiums for covering their workers.
  8. Medicare Prescription Drugs Rebates for Seniors: Medicare Part D enrollees who hit the Medicare prescription drug benefit gap in 2010 will automatically receive a $250 rebate check

Sources:
http://www.healthcare.gov/law/timeline/index.html
http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/key-health-law-provisions.aspx