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The Month When Americans Began to Take Back Their Health Care

Commentary
September 1, 2010By Janet Bauer

Years from now we may look back at September 2010 and celebrate it as the month when ordinary Americans began to take back their health care from the grip of insurance companies.

Thanks to the Affordable Care Act approved by Congress earlier this year, this month kicks off a host of basic protections for Americans who, up to now, have been largely at the mercy of health insurance companies. These new protections help level the playing field.

How does the Affordable Care Act affect you? For starters, if you are a young adult under the age of 26 and, like many in your age group, don’t have insurance, you can now join your parents’ health plan. It’s a simple rule that’s unaffected by your marital status, whether you live with your parents or are in school.

Next, the new law takes a big step forward this month in stopping insurance companies from denying care when you need it. They can no longer use an honest mistake on an application as an excuse to cancel your coverage when you get sick. Insurers also can no longer set lifetime or annual limits for what they spend on your care.

The ban against lifetime and annual limits represents monumental progress in protecting you when you get really sick. Up to now, about one out of every 10 cancer patients reaches the annual limit of their policies, and many who hit the limit go broke paying for their own treatments. The new law protects against this, making sure your insurance works when you need it most.

There’s more, including protections for kids with a chronic health condition. Starting this month, insurers can no longer refuse to insure your child because of a health condition your child already has, like asthma, for instance. Nor can insurers offer a plan that excludes treatment of these pre-existing conditions. Similar protections for adults will take effect in the future.

The Affordable Care Act now makes emergency services easier to use. Some insurance companies refuse to pay if you go to an emergency room that isn’t within their network of providers. The Act prevents new plans from creating such obstacles when you need help fast.

The Affordable Care Act also now makes it easier for you to use basic, primary care services. If you enroll in a new plan on or after September 23, you must be offered an array of preventive services like cancer screenings, diabetes tests, flu shots and smoking and weight-loss counseling — at no charge. Insurers must offer new health plan members a choice of primary care providers, and women can see an OB/GYN doctor without first getting a referral from their regular provider.

These preventive and basic care measures of the Affordable Care Act make our country better able to slow down the spiraling health care costs that now hurt individual Americans, businesses that offer coverage and the economy. It’s well known that when people consistently get basic and preventive health care they are healthier and end up needing fewer costly treatments later on.

Additional common-sense protections included in the Affordable Care Act will take effect in the future. Once all of them are implemented, we’ll wonder how we ever got by without them. And we may remember that the change began in September 2010.


Janet Bauer is a policy analyst with the Oregon Center for Public Policy. For more information about how the Affordable Care Act affects you, visit healthcare.gov.