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Linda Bergthold

Linda Bergthold

Posted: September 23, 2010 08:33 AM

Today, the Affordable Care Act is six months old. Big deal, you say. What has it done for me? You may be surprised. But you are not alone. Only a small percentage of Americans know what will happen as of the 23rd of September 2010 or what has already happened since reform's passage back in March.

The National Council on Aging posed 12 questions about the law to 636 seniors and found that fewer than 17% of them knew half the answers. For instance, only one in three knew that Medicare will offer free annual wellness exams.

In part because of general ignorance about what is in the law (as well as the many inaccuracies circulating in the media and the internet), the support for health reform is still low -- under 50% -- but think about it: if you haven't been sick or had contact with your insurance company or the health system lately, and you don't follow this issue carefully, how would you know?

So in case a pollster calls you to ask, or someone in your family does get sick and needs to know this -- here is what will be required as of Thursday September 23rd (or has already happened):

1) Preventive care will be covered without any co-payments, co-insurance or deductibles -- you can get some cancer screenings, flu shots, vaccinations for your kids, well baby visits -- all covered without out of pocket payments from you.

2) Children below the age of 19 cannot be denied coverage because they had a pre-existing condition -- for families of children who have been ill, this is a huge relief. It doesn't mean the coverage is cheaper, but for desperate families, at least it will be available without rejection. Some plans have already done this.

3) If you have no insurance at all because you have been sick or rejected for insurance for at least six months, you can sign up for a state "pre-existing condition" program and get coverage. Check out what Texas is doing in this regard. Check out your own state to find out if you are eligible. These programs are already working in many states.

4) Annual limits on coverage will be limited and lifetime limits will be banned. This may not mean anything to you if you have not had a serious illness -- but believe me, if you or a family member, with insurance, has ever faced those limits, they are quite terrifying. You can be in the middle of treatment for a serious cancer, reach your $100,000 annual or $1million lifetime limit and all of a sudden you face being without any coverage at all. This is new.

5) Adult children can stay on their parents' plan until age 26. (For some employer-based plans, this coverage may not start until January or the new plan year.) My friend's son had cancer and was about to be dropped from their plan just as his treatment was starting. Now he can still be covered. For young adults who are unemployed or work for companies without insurance, this provision will be very helpful.

6) More than 4 million seniors will be helped by changes in the law by the end of the year and many have already received $250 rebate checks on their "donut hole" prescription drug costs. The donut hole will continue to be diminished until it no longer exists by 2020.

And there are other changes that may be invisible to you -- a program to help companies defray the cost of their retiree medical costs; tax credits to small businesses to help them afford to buy health insurance for their employees; websites to help you figure out where to get insurance while you are waiting for the whole program to kick in by 2014.

So blow out some candles and sing or hum along ... "and many more..."


 
 
 
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03:02 PM on 10/03/2010
Healthcare reform was supposed to provide healthcare for people who do not have insurance. These changes are only minor adjustments for people who are already covered. There has been absolutely no progress for anyone who does not have insurance, they are still stuck out in the cold with no healthcare options whatsoever. Even if you pay $200 to $300 to visit a doctor, they still want another $1,000 to $3,000 in tests for even the most routine medical problems.
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HUFFPOST PUNDIT
redstateblues69
08:46 PM on 11/07/2010
I have insurance and I'm pleased because it can't drop me if I get sick and can't put caps on treatments which means my real estate won't be vulnerable to medical debt. That means I get to keep my assets and bequeath them to my children. Big progress!!!!!!!!!!!!!!!!!!!!!!!!!!!
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Damiano Iocovozzi MSN NP
03:08 PM on 09/26/2010
Ms. Bergthold, This is not health care reform but rather health insurance reform. True health care reform will come eventually in the way of a single payor system. Today's current system still contains the middleman, the health insurance carrier, which cannot discriminate or rescind when you get sick: they can just charge whatever rate they want which may be more than one grosses per month. That is still extortion as there are no caps to what can be charged. Single payor systems eliminate the middleman, but our country is a country of very strong lobbyists who have bought and sold politicians. The US middlemen make enormous profits from state sponsored extortion of the population. The screams of socialism and death panels are used carefully to manipulate the population so as to remain powerless in the face of extortion. Consider the US spends 1.2 trillion USD on medical futility, especially at the last six months of life because enormous profits are made there. 1.2 trillion USD would give ever human on the planet free basic medical care. Come to my web page at soonerorlaterbook.com for lots of free information, podcasts and blogs about medical futility and how to protect your loved ones from those nightmares.The American Medical Business Machine is also behind the status quo of the middleman for it makes enormous profits on natural human decline, disease and chronic illness. Damiano de Sano Iocovozzi MSN FNP CNS
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CaptRuby
Corporations are people my friend!
01:16 AM on 09/26/2010
When one read all of the above benefits, I wonder, you have to b crazy or completely selfish to oppose such a law.
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HUFFPOST SUPER USER
cbwHouston
"Courage is the power to let go of the familiar!"
11:27 PM on 09/25/2010
THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010: The making of that which will go down in history as yet another authentic American love story. Tweet next up: "THE PUBLIC OPTION!"
KIampfbeobachter
Misanthropic economic and political shaman
07:39 PM on 11/08/2010
Not the option. The only insurance in town. Coverage from conception (prenatal care) to death.

And this will even BRING COSTS DOWN.
07:24 PM on 09/25/2010
So what? United Healthcare cancelled me because I was late on Nov and Dec premium payments. I paid the whole thing in January but promptly got a letter saying they were cancelling me. (And I never filed a claim with them!) Then, out of the blue I get a letter from them in July offering me 'affordable healthcare' - with several different companies to choose from. Who I presume pay kickbacks to UH. The bill only helps those with coverage.
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CaptRuby
Corporations are people my friend!
01:15 AM on 09/26/2010
That's why universal HC is so important. So, the business of reforming HC in this country remains unfinished.

Wish the party of NO and blue dogs had not raised such a hue and cry, otherwise that option was on the table initially.
03:18 PM on 09/25/2010
Hi all. I am most disheartened by how much of a deafening silence on the potential benefits of the health legislation there has been since its release. Worse still is that the legislation has been completely demolished on the right without any organized public rebuttal. It is far from perfect and the economic benefits can be debated but the right has stolen the show, and much of it remains lies. There are those who are philosophically opposed to government intervention in healthcare, and there can be no adequate argument for them. But many are still afraid of supposed death panels, abandonment of the elderly, state sponsored food police, etc., etc. and there remain those who continue to perpetuate these ridiculous notions to whip up opposition. This needs to mark a seed change in healthcare but I fear the benfits have once again fallen victim to vitriolic politics.
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HUFFPOST COMMUNITY MODERATOR
VegasDealer
The calm before the storm...
06:49 PM on 09/24/2010
Happy Birthday!

Hopefully this will be a step in the right direction.

I just received my new open-enrollment package, and my premiums WENT DOWN for next year (adminstered by CIGNA).

Now, our story:
My wife has been a contributor to our society, but she fell ill recently. Just this year alone the costs of the original billing was nearly $600,000 and climbing. But because we have insurance the total cost was negotiated by the insurance company to about $60,000 TOTAL so far. This is exactly WHY the system is broken.

How can the insurance company negotiate to the costs down by 90%? I am told that it is because they have the "numbers" of those who they insure to be able to negotiate the costs so low.

Really? And exactly how many people live in the U.S.? There is some negotiation power!
10:00 AM on 09/24/2010
You have got to be kidding me!!!! I am a person who is for universal health coverage, voted for President Obama and then almost tossed my breakfast regarding this health care issue. I can get coverage in my state if I am denied coverage for pre existing condition, of course first I have to wait six months uninsured wtih my preexisting condition then I get lucky and only have to pay $585.00 per month for lousy insurance. You also forgot to mention that those of us who opt for a high deductible plan, saving on insurance voluntarily, are getting the royal treatment aka shafted on our HSA qualified purchases such as over the counter drugs. Before the law went into effect most insurance companies included one well visit a year for free. In trying to win points both parties sold out and the result is a garbage bill that is only good for fertilizer.
12:13 PM on 09/24/2010
Just curious how both parties sold out, when the Dems pushed it through without Republicans. I'm an independent, but thought I'd point that out.
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HUFFPOST BLOGGER
Jamie Schler
Writer at Life's a Feast & Huff Post blogger.
02:45 AM on 09/24/2010
The government, any government, is responsible for their population's safety, health and education. And as citizens, one has the right to be safe, healthy and well-educated (healthcare and education should be affordable and available) as much as it is in the government's power to offer these things. All those who are chanting for "less government, more liberty/freedom" do not know what they are talking about. What good is a country with sick people who can't be healed? And do these people understand that it only costs the government (thus the taxpayer) more money the sicker the population is? If people cannot get healthcare? I think Obama's biggest problem is not having spokespeople and the media continually explaining to Americans things like what is in this article, the benefits and real costs (for the gov't & for them) of so many gov't programs. America's biggest problem is ignorance of so many of their citizens.
12:30 PM on 09/24/2010
Jamie, who told you the government is responsible? Government has become more + more responsible as people have been less willing to take responsibility for their decisions and themselves-hence, generational welfare. I work in the school system and have seen hundreds of programs for the so-called underpriviledged-the bottom line is that you have to embrace an opportunity, and many do not. I take offense to your thinking that citizens who don't want government mandating all things as ignorance.
12:50 PM on 09/24/2010
Where is it stated that the government is responsible for your health + education? One has the right to be safe, but last time I looked no where in the constitution does it say free healthcare + education for all. Oh there I go-talking about the Constitution...probably don't like our founding principles either I'll bet. Some have become more + more dependent on government programs, instead of taking responsibility for themselves or their decisions. There will always be those who truly cannot help themselves, but we can all see that many take advantage of the system. I take offense to your saying that those who don't want government mandating healtcare and more gov't. programs are ignorant. We understand exactly what's going on, but just have a different set of values.
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Traynor
Oh....nooo! Empty Biooo!
03:04 AM on 09/25/2010
Crazie: Read your State Constitution. The Feds delegated the responsibility for education to the states. Most of the constitutions say something like "It is the paramount duty of the state to provide free, appropriate public education to all..."
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HUFFPOST BLOGGER
Jamie Schler
Writer at Life's a Feast & Huff Post blogger.
04:36 AM on 09/25/2010
What I don't like is the wonton and closed interpretation of the Constitution by so many right wingers just looking to defend their own ideology. You tell me how citizens CAN take responsibilty for their own health when care and insurance is unaffordable? When insurance companies make all of the decisions? How can they take responsibility for their own education when schools aren't taken care of or given the funding necessary to teach our kids in the best way possible or giving every single family the possibility of sending their kids to public school knowing that they will get a great education and opportunity to become/achieve what they can or want to? This is the government's (state or federal) responsibility. Why in the world do we have a government? Simply to declare war on other countries? No, the government should not make decisions for individuals and yes abuse of the system does exist (I do know that it is inevitable) but if the opportunities are just not there how can people do anything? Don't forget that we do have a public school system.
01:07 AM on 09/24/2010
Hey folks, try this one on for size:
Our government is completely broken. People that work for the government generally cannot hold a job anywhere else. The issue is basically the result of greed. Greed knows no political affiliation.

Personal Opinion: Most Lawyers (very few exceptions) are Liars and Crooks. All Politicians are Lawyers; Therefore, ALL Politicians are Crooks and Liars.

If these people were legitimate, why would they spend a million dollars fighting to get a job that pays under $200,000 a year salary? Does this sound like a sound decision? Really?

All the "Perks", never ending salary (for Congress & Senate), their own personal Health care system and tons of lobbyists with lots of money to give away. Wow. How could anyone say No?

Makes me sick - along with Wall Street Bonuses & Banker Bailouts. I know if I broke the law, I would be in Jail. What about the crooked bankers? They get a government job. Guess they know too much.....
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Jericho the Red
moderate before it was called liberal.
09:43 AM on 09/27/2010
you speak in great giant hyperbole..
and random rhetoric...
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429freckles
Ex Republican Now Devoted Democrat
09:47 PM on 09/23/2010
Personally, I am thankful that the bill passed. I pray that the Republicans do NOT gain control of the Senate & move to repeal it.
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Donnie4488
10:59 PM on 09/23/2010
Obama has said he will veto any attempt to weaken HC,I think as people ,and even businesses realize the benefits of the bill,pressure will be put on Republicans to leave it alone.Fingers crossed.
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doctor4kids
Incite civility and reason
08:21 PM on 09/23/2010
I write this post for those who champion "liberty" and "personal responsibility". Please don't ever take your health for granted. You didn't earn it. Oh sure, you can influence it by eating right, exercising, not smoking, getting regular check ups and just taking good care of yourself.

My husband did all of those things. He exercised, ate a really healthy diet, never smoked. He even had genetics on his side. His dad lived to be 90 and his mom who still works as a professor will celebrate her 90th birthday in a couple of months. That didn't protect him from getting a brain tumor. He's had multiple surgeries, radiation and chemotherapy. He's no longer able to work. Fortunately, he's covered under my health insurance and has received excellent care. He's too young for Medicare. If I lost my job, his "pre-existing conditions" would make it virtually impossible for him to get health insurance.

My point is that if this could happen to my family, it could happen to anyone. Health insurance is not like car insurance--if you can't afford to safely operate a car, you can take the bus. Health care is a right that civilized countries grants to its citizens; it shouldn't be left up to for-profit companies to make the rules. Most of the time we have insurance for the "what ifs" in life but sometimes they really happen and we need to make sure that quality health care is available for everyone.
11:59 PM on 09/23/2010
Thank you for sharing your story. We need to keep the good messages out their about the Reform Bill. It's a life saver for so many people.
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01:59 AM on 09/24/2010
9/24/10, To Rapersun: while I can sympathize with your plight, rights have gone to the n'th degree. Sorry, all the necessities of life are not rights. Be it h'care, home, food , transportation, phone/ internet/ tv; an education.
Start from the ground up; if everything were a right, no one would ever work for anything. This mindset started from the civil rights movement of yesteryear. Such has paralyzed many black people. ~~~Preston Weiters~~~
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CaptRuby
Corporations are people my friend!
01:22 AM on 09/26/2010
My heart goes out for you and your husband, and thanks for sharing your story.

Your efforts, I hope, will bring some senses to those who oppose such an important law, mainly due to ignorance.
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HUFFPOST COMMUNITY MODERATOR
Dosadi
Political agnostic
06:59 PM on 09/23/2010
All those who get scared when the republicans tell you to be afraid please raise their hands.  Now go away, some of us have business to take care of.

Scared wusses!
07:30 PM on 09/23/2010
Scared? no. Thoroughly disgusted with the Republican Party? yup. Find the continual whining and scare tactics tiring? yup. Bothered by the fact that people listen to this crap? That they are obviously trying to tear what is left of the middle class apart? you bet!

It Can't Happen Here...?
You bet it can and it will if people don't get their acts together mighty quick.
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HUFFPOST COMMUNITY MODERATOR
Dosadi
Political agnostic
07:37 PM on 09/23/2010
Good point.  The people need to gather themselves up, throw off the ravages of 8 years of constant scare tactics and think.  We have to get our act together.  Too many think the economic mess is over.  It's not.  Our economy cannot recover if the middle class has no money to spend.  The middle class has no money because they lack jobs.  Businesses are not hiring because they see no demand.  it is a vicious circle that can only be broken when the people get up off their butts and demand changes.  The Europeans are not afraid to take to the streets so why, in the country that boasts of more freedoms than anywhere, we are afraid to stand up and make the necessary changes? I agree with you 100% 120% if you like fox news that we need to get our act together pretty quick.
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HUFFPOST COMMUNITY MODERATOR
Dosadi
Political agnostic
06:52 PM on 09/23/2010
The new republican mantra; "I'm sooooo scared."


Wusses, all of them!
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Fractal122635
06:32 PM on 09/23/2010
These are the types of gross inaccuracies that they used to sell the bill in the first place.

Of course annual limits on coverage can be limited. That is the very definition of coverage.

More importantly, the ACTUAL effects of the law on average citizens is WHY the bill has no support.

Increased rates, and decreased coverage. The facts on the ground, as it were.
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HUFFPOST PUNDIT
Lorianne
ama vitam
06:46 PM on 09/23/2010
Actually, this bill changes little in that regard.
At present State insurance boards regulate insurance including rate increases and coverage limits.

Under PPAC, Federal regulators will perform the same function

And guess what?
It's just as easy to 'lobby' State regulators as it will be to 'lobby' Federal regulators for rate increases and coverage decreases.
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HUFFPOST COMMUNITY MODERATOR
Dosadi
Political agnostic
07:00 PM on 09/23/2010
I'm sooooo scared.  Oooooh!