Health care law includes no lifetime limits


Lost in the tea party/GOP attacks on health care reform is the sigh of relief millions of Americans gave Sept. 23, as the first elements of the new health reform laws took effect.

Among those millions are the hundreds of thousands, whose lives were first changed when they were struck with disease, and then almost destroyed, when an insurance company told them they could not get coverage.

As of Sept. 23, 2010, denial of insurance to those with a pre-existing condition is illegal.

Also illegal, as of yesterday, is cutting off hundreds of thousands of children of the insured. Companies must keep them on their parents' plans until they are 26. It is illegal to dump them when they turn 18.

Other features that kick in now are:

• Ending rescission. Insurance companies are no longer allowed to retroactively cancel policies because people make inadvertent errors on their enrollment forms. Insurers used this to avoid paying for care when their customers became very ill.

• Preventive care without co-pays. Enrollees need not cough up co-pays or co-insurance. The rule only applies to preventive care delivered by practitioners in an insurer's network.

• More freedom to choose doctors within their insurers' networks and freedom to receive covered care in the emergency room even if they are not pre-approved.

Perhaps the most important piece that kicks in is no more lifetime coverage caps.

In April 2008, Barbara Russum, an administrative assistant who lives in Chicago's Bridgeport neighborhood, learned she had cancer. Since then she has run up medical expenses of $350,000.

"And there is always the chance that my cancer can come back," Russum said.

Russum was one of another group of several hundred thousand who woke up yesterday morning, for the first time, without fearing that a relapse would push her past some lifetime limit set by an insurance company.

"For me, eliminating the lifetime coverage limit is a tremendously important achievement of the Obama administration and all those in the House and Senate who voted for health care reform," she said.

Although the major changes associated with the bill won't happen until 2014, Russum says the immediate improvements are so important to her that she has been energized to get the vote out on Nov. 2.

"Everyone should get out and vote. I know how I'll be voting. The party of no can go to hell," she said.

The 2014 changes will guarantee all Americans can get coverage, and provide millions of dollars in subsidies to help them pay their premiums.

Tax breaks for small businesses that provide coverage to workers have already begun.

Commenting in a Washington Post op-ed, the Kaiser Family Foundation's Drew Altman said, "The federal government that many regard as sluggish and ineffective has turned major elements of the legislation into reality right on schedule.

"It has set up a program to help people with pre-existing conditions get coverage through state or federal high -risk pools; established a program to help employers provide health insurance to early retirees; issued rebates to help pay drug costs for Medicare beneficiaries; provided tax credits to small businesses; and created a consumer-friendly web site,  that rivals anything coming out of Silicon Valley."

Public misunderstanding about the new law remains high, however.

A recent study by the nonprofit Kaiser Family Foundation found nearly half the country's seniors wrongly believe the law creates a new government panel to make decisions about end-of-life care for people on Medicare. A reflection of the right-wing's "death panel" lie, many say.

Interestingly, polls show large numbers who are opposed to the new law change their answers when questioned about specifics they don't like. They respond favorably to the actual health care changes when asked about them point by point.

Some Democrats running for reelection say the reform law will pick up support as time goes on. Senate Majority Leader Harry Reid is one of them. He began running video clips that show the crass response to health care reform by Sharron Angle, his tea party/GOP opponent for the U.S. Senate seat in Nevada.

The video shows Angle mocking health care coverage for autism and maternity leave. "I'm not going to have any more babies, but I sure got to pay for it on my insurance. Those are the kinds of things that we want to get rid of," Angle says.

In a statement yesterday, Reid campaign spokesman Kelly Steele said, "Sharron Angle's extreme and dangerous agenda for Nevada has included some exceptionally callous rhetoric, including calling out-of-work Nevadans 'spoiled' by unemployment benefits and saying that rape victims should 'make lemons into lemonade' by having their attacker's child, but mocking those suffering with autism - and in fact scapegoating their coverage for our nation's health care woes - is exceptionally cruel and represents a new low, even for Sharron Angle."

Photo: bobster855/CC

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  • The law also gives nurses more money to go to school and get advanced degrees so they can become primary care practioners and fill the huge gap left by doctors who followed the dollars .

    Posted by martin, 10/14/2010 9:06am (5 years ago)

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