Health Care Reform Provisions Take Effect Today

Key provisions of the new health care law that was ratified six months ago went into effect today.   Critics say they will raise the cost of insurance unbearably.  The White House acknowledges there will be increases, but they estimate premiums to go up by 1-2%.  Most independent estimates don’t expect huge huge increases.

Moreover, the benefits and protections of the reforms may be worth small premium increases to most people.  Some of them already went into effect yesterday!  There’s not been very much coverage, but what there has been has focused on these provisions.

  • Parents may keep their children on the family health insurance to age 26, if the child is not offered coverage through an employer.
  • Children can no longer be denied coverage because of pre-existing conditions.
  • Lifetime limits on essential benefits like hospital stays are abolished.
  • Insurers must cover preventive services such as immunizations, mammograms and colonoscopies, without charging consumers deductibles, co-pays or co-insurance fees.
  • All of those provisions are valuable and important protections.

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    It also

    bars insurers from canceling policies retroactively when a person gets very sick and runs up high bills. Insurers still will be able to rescind policies in cases of fraud and intentional misrepresentation. But they can’t cut you off when you need coverage most for a capricious reason

    That’s important. The complete and arbitrary power insurance companies had over people with serious illnesses was both wrong and disturbing!

    Another useful provision provides a short tern floor for limits on annual coverage in the short term, and eventually abolishes them. So if a person is in a car accident and incurs an unusually high amount of medical bills, they are protected. It is possible for an employer to apply for exceptions if the costs impose undue hardship, but basically, the consumer is protected.

    According to the White House site, if you purchase or join a new plan on or after September 23, insurance companies must also:

    Provide an opportunity to appeal coverage decisions: Consumers will be guaranteed the right to appeal insurance company decisions to an independent third party.

    Guarantee enrollees their choice of primary care provider: Consumers will have their choice of provider within the plan’s network of doctors, including OB-GYNs and pediatricians, without a referral, as well as out-of-network emergency care.

    These are good provisions.  More importantly, the changes that went into effect today take us one step closer to making sure everyone has adequate access to health care. Nothing is more important than that!