Health care reform starts today
Like it or hate it, today marks six months since the president signed the health care reform bill. It's also the first effective date in the multi-year implementation schedule. The reforms take place incrementally; the first are among the more basic.
Called the "Patient's Bill of Rights," the changes effective today include:
• Pre-existing condition discrimination ban, kids: Beginning today the 72,000 sick children (90,000 if you include those who are insured, but denied condition-related benefits) who were denied insurance because they had a pre-existing condition can now be covered. By 2014, that will include adults.
• Ban on dropped coverage: Nearly 11,000 Americans have been dropped due to a technical mistake on the application (this does not include fraud). Beginning today unintentional mistakes can not be the basis for dropped coverage.
• No lifetime caps: The 20,000 who quickly hit lifetime caps with serious, chronic conditions such as cancer will now be covered longer. To a lesser degree dollar limits will still be allowed until 2014, when they will be eliminated.
• Doctor & ER care: In a true emergency, one shouldn't have to worry about where they're treated. Beginning today companies can no longer restrict ER choice. While insurers can still provide greater benefits for in-network doctors, they can no longer choose which primary care doctor sees each of the 88 million people who will benefit from this provision.
• Right to unbiased appeal: This may not seem as exciting, but it is big. Until now not every insurer provided a right to appeal and if they did, patients appealed to the same insurer who denied coverage. Now new policyholders have the right to appeal to an independent third party.
• No-cost prevention: New policyholders will enjoy certain preventive care (e.g., mammograms, colonoscopies, pre-natal and new baby care) without copayments and deductibles.
• College students: Like many young adults, our son went uninsured as a full-time college student dependent after he turned 23. Now that age is bumped up to 26 for employer-sponsored plans. Two-thirds of college students are affected by this provision. Others use college-sponsored plans which are great for simple care (flu, colds, sprains), but tend to have very high deductibles and low coverage ceilings for more serious conditions.
Health care reform has many more, and in some cases more controversial, elements which will not take effect for up to three more years. Learn about these and other new options for the uninsured at Healthcare.gov.
Sholeh Patrick is an attorney and a columnist for the Hagadone News Network. E-mail sholehjo@hotmail.com