Health Insurance Articles
Three Consumer Benefits Of The Health Insurance Reform Law
2010-08-03
The nature of health insurance changed perceptually on March 23, 2010, when President Barack Obama signed into law landmark legislation entitled the Patient Protection and Affordable Care Act. It immediately affected 41 million Americans and will impact over 88 million by the year 2014. There are consequential health insurance benefits inherent in the legislation for consumers regarding insurance coverage parameters. The new law wrested control of health insurance protection and coverage from insurers and empowered the insurance consumers.
First, as of September 23, 2010, health insurers will no longer be permitted to charge a copayment for common health screenings such as mammograms, pap smears, prostate cancer x-rays, blood tests and blood pressure analysis. Additionally, there will no longer be a copayment required for routine vaccinations and other preventive care procedures. This provision alone will result in saving consumers millions of dollars, as copayments in HMOs and PPOs can be between $5 and $20 dollars per visit. For low income persons, these fees are sometimes not affordable, and patients will often forego these essential tests and services. Unequivocally, the overall consensus is that these reforms will save consumers billions of dollars.
A second consumer benefit of the health insurance reform law is consequential for insured persons with critical illnesses, such as coronary heart disease, congestive heart failure, kidney disease, diabetes or cancer. The new law eradicates lifetime benefits limitations under insurance policies. Additionally, insurers have been able, up until now, to rescind coverage on patients with serious illnesses and disabilities due to the subsequent expensive claims and predicted loss ratio. The new legislation prevents policy rescissions for insured with serious illnesses. Furthermore, it has created a high-risk pool for patients with pre-existing conditions. In fact, $5 billion has been allocated to assist states in funding an insurance pool for the uninsured and high-risk patients. By 2014, the new law will prohibit all exclusions on the basis of a pre-existing condition.
Third, parents are now permitted to continue coverage of unmarried children up to the age of 27 years. Continued insurance coverage under a parent's policy is typically less expensive than private health insurance. In this manner, there is not an underwriting evaluation requirement or the possibility of a denial of coverage based on the child's pre-existing illnesses or health care history.
The health insurance reform law has basically improved health insurance coverage for consumers by preventing limitations and rescissions and permitting parents to continue insurance for their adult children. Additionally, it requires that insurance companies write policies in plain language and establish a web portal for individuals and small employers to obtain critical information. All insurance companies will have to justify their proposed rate increases before a state-level review panel.
