This holiday season you may be surprised to find some gifts from the Affordable Care Act (aka health reform) in your stocking. I say "surprised" because a recent Kaiser Family Foundation poll found that the American public still doesn't know what is in the health reform law and what is not.
If you haven't been sick this year or are not included in the following categories of people who are benefiting from health reform, it makes sense that you won't have paid much attention. You may not experience concrete benefits until it is fully implemented in 2014. But just in case you know someone in these categories, here's the list of health reform "gifts" available this year (see my blog on the Health Insurance Resource Center for more details):
1. If you are 65 or older -- (and eligible for Medicare) -- seniors who are enrolled in Medicare Advantage plans (that's Part C or the managed care part of Medicare) may have seen their premiums reduced this year. Some may even have access to ZERO premium health plans. Seniors also now receive free preventive treatments and a rebate of $500 if their drug coverage hits the "donut hole" in 2011.
2. If you haven't turned 26 yet -- you may have been able to stay on your parents' health plan this year, even if you are working or don't live at home. 2.5 million young people had access to this benefit. And 90,000 children under the age of 19 could not be denied coverage because of a pre-existing condition due to a change that was implemented in 2011.
3. If you needed preventive care (or had the good sense to get it) -- you had access to it this year without a co-payment or deductibles.
4. If you were a small business owner -- with fewer than 25 employees and average wages of $50,000 a year, you were eligible for a substantial tax credit if you offered health insurance coverage to your workers.
5.If you have been uninsured for 6 months because you couldn't afford coverage or had a serious medical condition -- you could enroll in your state's "pre-existing condition insurance pool" and get coverage at a more reasonable rate. (Read this story about a woman who had criticized Obama for the health care law but then got cancer, apologized to Obama publicly because she was able to find coverage from her state's high risk pool.)
6. If you did accrue substantial medical bills this year, the law restricts annual limits on health insurance coverage.
7. And if you are an individual who buys insurance on your own, not through an employer -- you know how hard it is to get that coverage and how expensive it can be. But one of the benefits of health reform identified by only 38 percent of the Kaiser poll respondents is something called the "medical loss ratio". The MLR requires that health plans pay out at least 80 percent of your premium for actual medical care (85 percent if it's a large plan). That is, they can only spend 20 percent of your premium on advertising and other administrative costs. If they do not spend at least 80 percent on medical care, they have to pay a rebate to you, the consumer, most likely in the form of a reduced premium. I mention the individual buyer of coverage here, because most insurers who offer plans through the group market (small or large) likely meet those 80 percent requirements today. It is the insurer who markets to individuals that may be failing to meet the 80 percent requirement. We can thank HHS for holding the line on the MLR regulations to the benefit of the rest of us. The MLR may be one of the best holiday gifts of all.
Did you already know most of this? Congratulations, but you are in the minority. The Kaiser poll also found that the majority of respondents had heard very little from the media about health reform in the past thirty days, other than what is being said in the Republican debates. In the midst of a great amount of doom and gloom over the economy, and constant attacks on the president and the Affordable Care Act, it's important to remember that some good things have been done for the most vulnerable of our friends and family. Pass it along!
Follow Linda Bergthold on Twitter: www.twitter.com/lab08
If my insurance company can make a profit without taking the $96 and change from my SS check, and also give me drug insurance at no addition cost, why can't the Federal Government at least break even?
Can't believe how much information you left out of your post.
Before AFA, American had one of the highest infant mortality rates in the industrialized world. Higher than the infant mortality rate of Canada and Britian, demonized for their socialized medicine. About twice as high as the infant mortality rate of France. About 3 times higher than the infant mortality rate of Singapore. (I got these states from OCED.)
The states in the Bible belt, Mississippi, Alabama, Tennesee and South Carolina had the highest infant mortality rates - and the place with the highest infant mortality rate was Washington DC, home to all the insurance company lobbyists.
It always seemed strange to me that the loudest opponents of Obama-care came from the Bible belt. After all, Jesus spent most of his time healing the sick. Never once did he say anything about health insurance.
I know Obama-care has a healthy mother provision which guarantees pre-and post natal care to all expectant mothers. What effect has that provision had? I'd appreciate a follow up article.
https://sites.google.com/site/elderabuseinhospitals/
Let's face it. If you are eligible for Medicare you are insured. Perhaps not perfectly but you are insured. That is why the Obama legislation is a fig leaf on a fatally flawed health-care/insurance system.
All this Cholesterol crap and the high dollars we pay only to make ourselves SICK (and I mean sick) and in some cases DEAD! This is not the only medical scam against the American Public..IF you really care to see what's going on see the VIDEO "Under Our Skin". It will shock you!!
Now, you were saying?
What was all the fuss about with "ObamaCare," a demeaning catch-phrase
invented by Republicans? All that noise, shock an awe about this healthcare
reform bill and only a dozen comments.
The "right" sure does have their finger on the pulse of the American people...NOT.
Thank you, President Obama.
The right wing sat in the scorners seat over social security, Medicare, the Pure Food and Drug act, child labor laws, the forty hour work week, civil rights, just to mention a few. They seem to believe that life was so much better during the 19th and early 20th century because after all, that seems to be where they want to go back too. Too bad the right wing always sleeps walks through history.
There’s never been a "Golden Age" of right wing governance. You don’t produce one when all your only use is to uphold the status quo.
If you think the Affordable Care Act is bad, just see what the right wing can contrive. They had nearly complete control at the start of the 21st century and they did nothing!
America needs to come to understand that the right wing is all blow and no go!
Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the "h" on my Obama bumper sticker, so that it read, "Got nope" instead of "got hope." I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.
So this is my public apology. I'm sorry I didn't do enough of my own research to find out what promises the president has made good on. I'm sorry I didn't realize that he really has stood up for me and my family, and for so many others like us. I'm getting a new bumper sticker to cover the one that says "Got nope." It will say "ObamaCares."