It has been observed over the past few months that if the American public actually understood the Affordable Care Act, they would support it heartily. Who, for example, doesn’t want cheaper and better access to health care for everyone? And drop the deficit in the process? The biggest problem with the Act is not hard to figure out, though. There has been so much political infighting and mudslinging going on among all our representatives in Washington that any benefits of the reforms are either completely misunderstood, lost in translation, or cloaked in so much government-speak that we have no idea what to make of them.
Another problem with the legislation is that is rolls out over a long, long period of time, in bits and pieces. Some parts are in effect now, some parts come into play in 2012, with 2014 being the really big year. We have enough trouble waiting two months for something, let alone four years. And there are calls now to repeal most of it, even if most of it isn’t yet in force. All in all, a pretty confusing situation!
Still, significant portions of the new consumer protections in the Affordable Care Act are already making the lives of American families better. We previously went through some important preventive services the Act installed. Here are some more examples of its benefits: the way the consumer protections in the legislation deal with some of the more notorious and unfair practices of health insurance companies.
- Can no longer revoke or take away your health insurance coverage based on an unintentional mistake made by you or your employer on an application. This is known as rescission of health coverage.
- Can no longer deny coverage to children younger than 19 because of a pre-existing condition. Until this reform, plan providers could refuse to accept anyone because of a pre-existing health condition. With this law, health plans that cover children can no longer exclude, limit or deny coverage to a child under the age of 19 solely based on a disability or health problem that a child developed before coverage was sought. This applies to individual plans as well as to employer-provided health plans issued after 23 March 2010. This rule applies whether or not a child’s health problem or disability was discovered or treated before coverage was applied for. This protection goes into effect for adults as well in 2014.
- Must allow children up to the age of 26 to stay on, or be added to, their parents’ family health plan.
- Must stop putting lifetime dollar limits on coverage. Annual dollar limits are being phased out between now and 2014.
- Must provide consumers their choice of any available primary care doctor or pediatrician in the plan’s provider network.
- Must allow access to out-out-network emergency care without prior authorization or higher cost sharing that would otherwise be charged for out-of-network facilities or care.
- Must meet specified basic standards when considering an appeal of a denied claim. The law also strengthens a policyholder‘s right to an independent ‘external review’ when an insurer’s ‘internal review’ supports or upholds a denial of claim.