Health reform is already affecting you

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Doug Hill
Monday, March 19, 2012

This month is a major milestone—it marks the two-year anniversary of the Affordable Care Act (ACA) being signed into law by President Obama. Whether you supported or opposed health reform when it passed, you’re probably already benefiting or will soon benefit from it. Here’s how:

If you have a pre-existing condition or disability, ACA impacts you. Already under the law, insurance companies are banned from discriminating against the 94,700 Wisconsin kids with pre-existing conditions. In 2014, adults with these conditions will be protected, too.

If you have private insurance coverage, ACA lets you keep it while enhancing your coverage. I mentioned the pre-existing protections above, but insurers are also banned from having lifetime limits and dropping you because of an honest mistake on your application. Yearly limits are phased out by 2014, and parents can now keep children on their health plans until age 26. We’re also going to see more bang for our buck due to something called the Medical Loss Ratio. Fancy terms aside, this means insurers will have to spend more of your premium dollars on your medical care rather than marketing and lobbying.

Insurance is also required to offer many preventive services, such as screenings and checkups, free. Seventy-five percent of care costs come from preventable chronic diseases such as Type 2 diabetes and heart disease, so if we can get a handle on these, we’ll save money and lives.

If you’re a woman, ACA affects you. Starting in 2014, insurers won’t be able to charge higher premiums because you’re a woman. All of Wisconsin’s most popular insurance plans now charge a 40-year-old, nonsmoking woman more than a 40-year-old, nonsmoking man. Women also get many free preventive services aimed at women’s health.

If you’re a small-business owner or individual who is uninsured, ACA impacts you. You’ll be able to buy private insurance through a competitive marketplace called an “exchange” by 2014. By forcing insurance companies to compete, exchanges will drive down costs, guarantee choice and put us in control. Last year, 62,800 small Wisconsin businesses qualified for tax credits to help with health coverage costs. For individuals, roughly 477,000 Wisconsinites with moderate incomes (for example, a family of four making up to about $90,000) will get tax credits to help with costs of health insurance through these exchanges.

Finally, if you’re a senior, ACA affects you. You stay on Medicare as always, but it’ll be improved. First, all 918,300 Wisconsin Medicare enrollees get access to free preventive services such as mammograms and colonoscopies. Second, 59,345 Wisconsin seniors on Medicare Part D got prescription drug discounts totaling $37.9 million when they hit “doughnut hole” coverage gap last year. Third, Medicare’s solvency is extended due to focusing on preventive care and fighting waste.

During this anniversary, please share with family and friends how health reform impacts them. You can also always visit the easy-to-use website, healthcare.gov, for more details.

Doug Hill (email djh1967@msn.com) is director of Know Your Care Wisconsin (facebook.com/KnowYourCareWI), a nonprofit group devoted to educating citizens about how the Affordable Care Act impacts them.

Last updated: 7:55 pm Thursday, December 13, 2012

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