Let's review what has happened in a year since health reform became the law of the land. We know that most of the biggest reforms (exchanges, a full ban on pre-existing conditions discrimination on adults, affordability credits and the individual mandate) does not go into effect until 2014. But we also know that many reforms that have already gone into effect - such as the ban on pre-existing conditions exclusion against children, small business tax credits, Medicare drug rebates, strengthening state regulators, Medical Loss Ratio requirements and a ban against insurance companies dropping coverage when you get sick - are helping save and change lives.
When I say it is saving and changing lives, I am not speaking in code. It's literal. The Department of Health and Human Services reports that 4 million seniors have been helped by the $250 Medicare drug rebate last year, and drug rebates have already totaled $38 million just since the beginning of 2010.
Through provisions of the Affordable Care Act, nearly 4 million people with Medicare who reached the program’s Part D coverage gap in 2010 have received a one-time, tax-free $250 rebate check. U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced today that a similar number of Medicare beneficiaries are likely to enter the coverage gap in 2011 and will benefit from additional Affordable Care Act provisions that work to reduce and close the “donut hole” by 2020. Already, nearly 48,000 Medicare enrollees have saved $38 million – an average of $800 per person – thanks to a new 50-percent discount on covered brand-name drugs in the donut hole.Many of these seniors would have been forced to choose between filling a prescription and paying their heating costs last year if health reform had not happened. Many more would have had to skip taking their medications or take less than the recommended amount because they could not afford it.
Today, the Department of Health and Human Services (HHS) released a new report showing that in less than two months, more than 150,000 seniors and others with Medicare have received an annual wellness visit. This is a preventive benefit now covered by Medicare free of charge when obtained by a participating health care professional, thanks to the Affordable Care Act, along with many other recommended preventive services. The report also shows that this enhanced preventive benefits coverage will lower costs, including lowering Medigap premiums for employers, states and people with Medicare.
4.5 million Americans and 5000 employers have been helped by the Early Retiree Reinsurance Program to keep their early retirees covered and reduce costs:
Health and Human Services Secretary Kathleen Sebelius today released a new report showing that the Early Retiree Reinsurance Program (ERRP) created by the Affordable Care Act is reducing health care costs for early retirees. As of December 31, 2010, more than 5,000 employers had been accepted into ERRP, more than $535 million in health benefit costs have been reimbursed through the program, and those payments have helped benefit more than 4.5 million Americans.Remember, these are early retirees, i.e. people not eligible for Medicare yet. So this group does not overlap the seniors we just talked about.
And let's not forget that thanks to health reform, we are seeing real parity for women in health insurance coverage. The law puts an end to the disgusting practice of insurance companies that used to consider simply being a woman a "pre-existing" condition.
Thanks to the Affordable Care Act, that’s all changing and women and their families are eligible for important new benefits that will ensure they have access to better care at a lower cost.Today, if you get sick, your insurance company can't simply drop you. Today, your insurance company must spend 85% of the premiums it collects (or 80% in small group and individual markets) on actually providing care, and if they don't, they owe you a check at the end of the year. Today, there are high risk pools for people with pre-existing conditions. Today, almost 1.2 million Americans under 26 could benefit from a legal mandate that requires their parents' insurance companies to cover them.
Women with insurance will benefit from the law. If you are in a new insurance plan, you can choose the primary care doctor or OB-GYN in your insurer’s network without a referral. Go to your insurer’s website or call the customer service number to find out which providers are in your network.
Recommended preventive services, like mammograms and flu shots, are now available at no out-of-pocket costs to you, if you are in a new insurance plan. This means that your insurance company cannot charge you a deductible or copays.
Health reform changed the life of a family in Brooklyn Park, Minnesota, with a 3-year old boy who was born with a severe genetic disorder requiring lifelong care. In an email, Joe Biden told the story of little William:
Justin and Kari live in Brooklyn Park, right outside of Minneapolis. They're parents to three children. Their three-year-old, William, was born with a genetic disorder called tuberous sclerosis complex.Democrats.org has also released a video telling the story of William, and starting a campaign called "Next to you" - calling on Americans tell the stories of people they know who have been helped by health reform. Here's William's story:
For the rest of his life, William will wrestle with tumors in his brain, his heart, his kidneys, his skin, and possibly other major organs. He must take medication to control seizures and faces the threat of kidney disease.
What Justin and Kari want for William is a future. And because of health reform, that's what he'll have.
Today, insurance companies are no longer able to discriminate against William because of the condition he's dealt with since birth. Now, Justin and Kari know they'll be able to get the kind of care that William needs -- today and into the future.
Do you have a health care story? If so, please go to Next to You and tell your story.