On this, the second anniversary of the passage of health care reform, one thing seems clear. If they say, "one must have the courage to lose sight of the shore in order to discover new oceans," then some of us are paddling the health care boat one way, while others are desperately trying to pull us back to the beach.
This month marks two years since the passage of the historic legislation known as the Patient Protection and Affordable Care Act. However, you might never know it from watching election coverage with its many lawmakers and candidates mired in heated rhetoric over the law's merits and the benefits it has delivered.
What year is this again???
The prominent role health care reform still plays in today's public discourse is a testament to its political usefulness. Republican candidates and lawmakers cling to campaign promises of repeal, even though the law has already made significant and life-changing inroads for portions of the American public. So, two years later, as its provisions run another gauntlet at the Supreme Court this spring, I am reminded of why I personally fought so hard for its passage to begin with.
I remember visiting with lawmakers on Capitol Hill during the days and months after my brother Eric's death in 2009, asking for changes that would enable people with pre-existing conditions to get insurance coverage that my very own brother was denied. I remember writing numerous letters, attending countless rallies and adding to the civic dialogue over the best and most important ways to improve our society's ability to care for itself, and remove the obstacles that stood between our most vulnerable members of society and access to health care. I remember gathering signatures and stories from thousands of supporters who all wanted the same thing I did: fairness and equality when it came to health care.The Patient Protection and Affordable Care Act's second birthday comes at a time of renewed, campaign-driven debate over health care reform, its benefits and costs. So, as the law hurtles toward the Supreme Court, it's worth examining the benefits it has already delivered for many Americans.
- Over 105 million Americans no longer have a lifetime limit on their health insurance plan, which ensures their coverage will be there when they need it most.
- Over 76 million people are protected by new medical loss ratio 80/20 rules, which require insurance companies to spend at least 80 percent of each dollar on health care benefits instead of overhead, executive salaries or marketing.
- Nearly 50,000 people have gained coverage through the Pre-Existing Condition Insurance Plan (PCIP), which provides coverage to Americans who have been uninsured because of a pre-existing condition.
- As many as 72,000 uninsured children can obtain health care coverage through 2013, thanks to new rules that prevent insurance companies from denying coverage to children under the age of 19 because to a pre-existing condition.
- An additional 90,000 children are seeing the current coverage limitations related to their pre-existing conditions eliminated because of these same new rules.
- In 2011, 2.5 million young adults gained health insurance through their parents' plan through the age of 26, including 1.3 million minority youth.
- In 2010, four million people with Medicare who fell into the "donut hole" received 250 rebate checks and in 2011, nearly 3.5 million people with Medicare who fell into the donut hole received a 50 percent discount on their covered brand name prescription drugs, saving over $2 billion.
- 32 million people with Medicare received free preventive services, such as mammograms and colonoscopies.
- Over 10,000 people are no longer at risk of having their coverage dropped each year because they got sick or made an unintentional mistake on their application.
- Approximately 54 million people with private insurance received free preventive care in 2011 due to new rules eliminating co-pays and deductibles for preventive services.
- Up to four million small businesses became eligible for tax credits that help make health insurance more affordable.
- By the year 2014, most of the law will be fully implemented. Considering the substantial advances made in just the first two years, I am extremely optimistic about what it will mean for all Americans once the law is completely enacted.
Of course, real people with real stories can paint an entirely different picture, and one not so easy to discount. Since I formed the Eric De La Cruz Hope for Hearts Foundation in 2010 in memory of my brother, I've had the privilege to meet many such people. People like Sean Semon, a 35-year-old Las Vegas resident who was dropped by Aetna when a pre-existing condition made an expensive heart transplant necessary. Or patients like 24-year-old Colby Salerno, also suffering from a form of cardiomyopathy diagnosed at the age of 12, who has been living in a Connecticut hospital for four months while awaiting a donor heart for transplant.
Hope For Hearts has been assisting both Sean and Colby, and their families, and I'm proud to say we've seen good things happen for both, specifically because of the passage of this law. Sean was accepted just this month to receive coverage under the Pre-Existing Condition Insurance Plan (PCIP), created as a provision of the Affordable Care Act. And thanks to health care reform, Colby now remains eligible for coverage on his parents' insurance plan for another two years, well beyond what was previously possible. For both Sean and Colby -- and their families and friends -- the benefits of the Affordable Care Act are very real. And both would be affected in adverse ways, should health care reform be rolled back.
If health care reform were repealed, either by the courts or by a new president, one thing is certain to me: We would be turning back the clock on millions of Americans. Tangible, often life-changing benefits, that are making a difference in the lives of real people, like Sean or Colby, would be taken away. Lives could come undone, something I've had the misfortune of experiencing first hand.
Insurance companies have wielded too much power for far too long, and we've determined the course we've been on has not been sustainable. The new health care law has given all Americans better access to more affordable health care. It's not perfect, but it has set a new direction that will lead to more patient protections and greater health care freedoms for millions of people. The Affordable Care Act has given all of us new rights. We cannot afford to forget why we fought so hard to win them in the first place. It's new land and territory definitely worth continuing to paddle for.
If you'd like more information on the author's foundation, Eric De La Cruz Hope for Hearts, log on to the organization's website at www.HopeforHeartsFoundation.org. Figures & statistics provided by the Department of Health and Human Services at www.HHS.gov.