Rep. Napolitano Welcomes New Health Care Reforms Coming Into Effect Today
(Washington D.C.)- Today, Rep. Grace F. Napolitano welcomed the first wave of reforms stemming from the Patient Protection and Affordable Care Act – the health care “Patient’s Bill of Rights” applying to all new health plans. The new rules prohibit insurers from denying coverage to children with pre-existing conditions, eliminate lifetime coverage caps, require free preventive care for all new plans, and allow young adults to stay on their parents’ plan until age 26.
“These critical, common-sense reforms will give some peace of mind to Americans who worry about losing healthcare coverage for themselves or a loved one,” Napolitano said. “More children will be able to find coverage, and outlawing the worst industry practices will allow patients to count on their healthcare being there when they need it most.”
New protections for health insurance plans beginning on or after September 23:
• Prohibits insurance companies from dropping coverage. Small application errors cannot be used to deny coverage for patients after they get sick.
• No discrimination against children with pre-existing conditions. Children cannot be denied coverage for a pre-existing condition as they were in the past.
• Eliminating lifetime limits on insurance coverage. Lifetime dollar limits on essential benefits like hospital stays will be prohibited.
• Extending coverage for young adults to age 26. Youth can remain on their parents’ plan until age 26. Young people previously lost coverage at age 19 if out of school and at age 23 if in college.
• Regulating annual limits on insurance coverage. New rules will sharply restrict the use of annual dollar limits on the amount of insurance coverage a patient may receive.
• Free preventive care. New plans will be required to provide preventive care services like mammograms without charging a deductible, co-pay, or co-insurance.
• Greater rights to appeal for patients. Patients will be able to appeal insurer’s decisions through their plans’ internal review processes and via an independent, third-party reviewer.
• Ban on limiting choice of doctors. People who purchase a new plan will be able to choose their own doctor within their insurer’s network.
“For these reforms to be effective, people have to take charge and know how to make the most of them,” Napolitano said. “Take it upon yourself to learn, ask questions, get educated, and inform others. For small businesses especially, many do not realize the savings and tax credits for health insurance that are available. Those credits will help lower insurance costs and stimulate the economy only if small businesses know how to take advantage of them.”
If a business has fewer than 25 employees and less than $50,000 in average wages, it could qualify for a credit worth up to 35% of the premiums it pays. These same credits will cover 50% of the cost starting in 2014. These credits have been available since health care reform was signed into law in March.