I have a friend who is a firm believer in the concept of a birthday week; in her view, a single day just isn't enough for celebrating.
She would love the party that's happening this week to celebrate the second anniversary of the Patient Protection and Affordable Care Act, or ACA. Many organizations, including the National Health Law Program (NHeLP), are using the whole birthday week to celebrate the changes that health care reform is making for individuals all across the nation.
Like all two-year olds, the ACA is still growing, and some of its happiest days are still a year or two away. And also like many two-year olds, some observers can only see the growing pains, not the progress.
So let me play the role of proud family member and do a little bragging -- because the ACA has already changed health care in ways many people might not realize, and even more important reforms are around the corner.
Here are some highlights of the progress we've made so far and where we're going.
- Medicaid will be expanded to cover an estimated 16 million more adults.
Many Medicaid providers will see their payment rates rise at long last. For seniors and persons with disabilities:
- "Part D" prescription drug costs have already gone down.
More individuals can receive services in their homes so that they are not forced into nursing homes or other institutions. Already underway: major steps to stop gender discrimination. For example, starting in 2014 insurers can no longer consider pregnancy, caesarian sections, or domestic violence a "pre-existing condition."- Two and a half million more young people have been insured over the last two years, thanks to the ACA letting them stay on their parents' insurance until the age of 26.
Insurers can no longer exclude a child under the age of 19 for a pre-existing condition.For people with private insurance:
- Most private insurance programs have had to get rid of their lifetime dollar caps.
Subsidies are in the works to help those who might struggle to make their premium and deductible payments.- The nine percent of the population that speaks English less than "very well" will get language assistance to help them get the medical care that they need.
Most health insurers can't discriminate against a person because of her race, ethnicity, language, gender, age or disability status.For those without insurance:
- Insurance plans offered through the state exchanges will cover a wide range of services as Essential Health Benefits.
Beginning in 2014, states will have the option of offering a basic health plan to people who are priced out of the private insurance market but may not qualify for Medicaid. In addition, subsidies will be available to reduce a family's cost-sharing expenses (copayments and deductibles) and annual cost-sharing limits. To find out more about any of these changes and learn about health care reform, check out NHeLP's ACA anniversary page and look for our "Top 5" series. We've been adding a fact sheet a day all week to help people learn about the ACA.
Read up now, because next week the Supreme Court will be hearing arguments about health care reform, and given the rhetoric to date it will take a keen eye to distinguish fact from hyperbole from outright fiction.
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