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..."