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Affordable Health Care Act Patient Bill of Rights: Change in Small Doses

Affordable Health Care Act Patient Bill of Rights: Change in Small Doses

Ninety days after signing the Patient Affordable Health Care Act into law, the Obama administration issued regulations to implement the Patient Bill of Rights, which includes provisions that begin on September 23 for most plans:

  • Insurers will no longer be allowed to turn down children because of pre-existing conditions.
  • A ban on lifetime limits, as well as a phasing out of annual limits.
  • End of rescinding policies of people when they are sick.
  • Guarantee of choice of primary care doctors and pediatricians from a plan’s network and no need for referrals for OB-Gyns or emergency care out-of-network.
  • Adults under age 26 will be allowed to stay on a parent’s policy. (Some insurers have already made this change.)

Beginning on July 1:

  • People who have been unable to secure medical insurance due to a pre-existing condition will have access to the Pre-existing Condition Insurance Plan (PCIP). This is a temporary program, ending in 2014, when insurers will no longer be able to refuse coverage to adults with pre-existing conditions.

Beginning in January:

  • Insurers must spend at least 80 percent of premium dollars directly on medical care, and 85 percent for larger groups, with the difference to be refunded to the consumer. (This has resulted in insurers attempting to change the way they label expenses.)
  • Insurers will be required to publicly disclose their rates on a new national consumer website.

A statement from the American Cancer Society Cancer Action Network today reads, in part:

“These regulations will help to expand patients’ access to health care and ensure that insurance companies cannot cut patients off from care because of arbitrary annual and lifetime benefit limits, unfairly drop them from coverage through rescission or deny children coverage because of a pre-existing condition.”

“By eliminating arbitrary annual and lifetime benefit limits and strongly enforcing other patient protections, the Affordable Care Act will help patients feel more secure in knowing that they will be able to get the care they need, when they need it.”

Many of the legislation’s provisions will not take full effect until 2014. Meanwhile, a Kaiser Family Foundation survey revealed that consumers in the individual market were hit with a 20 percent increase this year on average.

Many individually insured people already had, or are switching to high deductible plans, with one in four reporting an annual deductible of $5,000 or more. (Count me in that number.)

In an effort to help people in the individual market, states will have more power to review and prevent unreasonable rate hikes.

Just how many people in the individual market will lose their coverage due to cost over the next few years remains to be seen.

Immediate relief will be felt for those who have financial means, but have been refused by insurers. For others who do not get health insurance through their employer, things will very likely get worse before they get better. It’s a start.

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26 comments

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12:20AM PDT on Jun 27, 2010

I have always carried a high deductable for the past fourteen years or more because i have been reasonalbly healthly.
My reasoning was that one trip to the E.R. hospital via ambulance would cover the high deductable, as i stated prior, I unexpectantly had the misfortune to suddenly be hospitalzed for seven days.
To me carrying that high deductable was the best decison I ever made, i did not rush out of the hospital, stayed there without worring and reciecved the proper care and have not been back to a hospital.
To me carrying a large deductable keeps my monthly payments lower, and i try to take good care of my self..Hope I was abe to shed some light on high deductables, and how they were cost effective to me.
Most of us are blessed with the good fortune to carry two Insurances, Medicare and a supplemental my supplemental would have a high deductable.as mentioned one trip to the E.R you have met the deductable.end of story.
As they say pay now or pay later but you will pay..

1:51PM PDT on Jun 26, 2010

While we are having "change in small doses", people are dying because they cannot buy health insurance at all. The only thing "change in small doses" is good for is the panhandler on the street corner - and, even he/she can't survive on such small change any more. This is NOT change I can believe in. How about you?

8:07PM PDT on Jun 25, 2010

I am for healthcare for all, but I think we should have started with insurance reform.

I broke my leg at work in a couple places 3 years ago and their insurance refuses to pay for it because they said I broke it before. That's news to me-this was the first time I broke ANYTHING. Unfortunately now I have to take major action because they owe a $30,000 hospital bill (and a couple other reasons).

11:26AM PDT on Jun 25, 2010

Where's the "affordable" part?

3:46AM PDT on Jun 24, 2010

thanks for the post

1:17AM PDT on Jun 24, 2010

Americans across the country are already seeing the effect of the health care bill. Do you feel the changes in the health care payment system will be better for America? what does the new health care bill mean for middle class americans?
share your opinion at http://alotofdrugs.blogspot.com/2010/06/obama-plan.html

11:55PM PDT on Jun 23, 2010

Now if I could figure out how to keep my back from not getting bent out of shape... *sigh* All is well.

8:54PM PDT on Jun 23, 2010

My take on the current healthcare "reform" measures:
"The mountain labored and brought forth.......................................................................................................................a mouse." (Aesop's fables)

1:29PM PDT on Jun 23, 2010

To Barbara M. I moved to Canada from the US 40 years ago & have never regretted it. In the US, I had to beg on the street for enough money to get a doctor when my husband's temperature went to 104 & spiking (the doctor said there was danger of brain damage but the ER would turn him away without health insurance). In Canada, I might have to wait 6 months for a hip replacement, but I know no one is on the street begging for the money for health care in an emergency.

1:25PM PDT on Jun 23, 2010

If we have to take small steps to get where we want to be so be it. If we want large steps we did to change the dynamics of Congress.

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