As we wrap up this blog series, 20 Days of ACA: Lifting Latina Voices for Health Reform, we want to highlight just some more of the consumer protection put into place by health reform. We also want to talk about the big picture – what health reform will look like in 2014 when all the pieces are implemented.
We have already talked about how the ACA prohibits health insurance companies from denying plans to consumers with “pre-existing conditions.” And we have also talked about the rule requiring insurance companies to allow adult children stay on their parent’s plan.
Here are just a few more protections, under the Patient’s Bill of Rights that will make health insurance better, fairer and more reliable:
- Protects your Choice of Doctor: You will be able to choose any primary care physician (and pediatrician for your child) within your health plan’s network. Also, you will no longer need a referral to see an OB-GYN.
- Ends lifetime limits on coverage: Before health reform, insurance companies could limit the dollar amount of care they cover over a year and over the entire time you are covered under their plan. This disproportionately affects people with chronic illnesses, people with disabilities, and people who have been diagnosed with a health condition requiring prolonged treatment, such as cancers. Under health reform, lifetime limits on most benefits are prohibited and annual limits are restricted and phased out.
- Ends unjustified insurance cancellation: Insurance companies cannot drop your coverage because you made a simple mistake or forgot to provide information.
- Stricter scrutiny on proposed rate increases: Insurance companies requesting premium increases must make their case publicly. Additionally, HHS will review proposed increases for states who do not have resources to conduct these reviews themselves.
- Your money spent on health care, not CEO bonuses: The new law requires that at least 80% of the money you pay insurance companies for coverage (or premiums) be spent on direct medical care and quality improvement, rather than administrative costs.
- Removes barriers to emergency care: You will be able to seek emergency care outside of our plan’s network without prior approval from your health insurance company.
Many of these protections do not apply to ‘grandfathered’ plans. However, over time, more plans will lose their ‘grandfathered’ status and will comply with these new rules. The Patient’s Bill of Right can be found here. All of the government’s online resource about health reform can be found at www.healthcare.gov.
The Big Picture: What health care will look like in 2014
Throughout 20 Days of ACA, we have talked about ways access to health insurance and health will be expanded as we move closer to 2014. We have discussed community health centers, Medicaid expansion, and the Affordable Insurance Exchanges.
Today, I want to touch upon some final remaining pieces that hold all this together.
- Starting in 2014, employers must provide health insurance coverage or face penalties.
- Also starting in 2014, U.S. citizens and permanent residents, with certain exemptions, are required to carry health insurance. Penalties for those not carrying health insurance will be phased in. And again, federal tax credits and subsidies are available to help families enroll in new plans offered on the Affordable Insurance Exchanges.
All of the pieces of the ACA work together to expand access to millions of folks living in this country. That’s why the decision of the Supreme Court will have a major impact. The Supreme Court is reviewing the constitutionality of two parts of the law: (1) the requirement that all purchase health insurance or face a penalty and (2) the Medicaid eligibility expansion.
And as we move closer to 2014, there is much to look forward to.
We look forward to families being able to use the services of community navigators to help them enroll in plans on the insurance exchanges. We look forward to the creation of new community health centers throughout the country. We look forward to streamlined procedures for Medicaid enrollment for nearly 6 million Latinos. We look forward to greater access to preventive health services, like contraception. We look forward to more legislation that will build upon the ACA to dramatically reduce health disparities, like the Health Equity and Accountability Act (H.R. 2954).
And we look forward to a future where all Latinas can live with salud, dignidad, y justicia!