Health reform measures in effect today

It’s been debated, loved, hated, voted, rewritten, protested and glorified. It’s been a partisan issue and even divided some members of the same political party, and it’s been mostly quiet since it was passed.

Today, that changes.

Eight provisions of the Patient Protection and Affordable Care Act are going into effect today, according to a press release issued by The White House Office of the Press Secretary. This is the new Patient’s Bill of Rights.

Extension of coverage

for young adultsAmong the provisions that take effect today is the extension of coverage for young adults. Young people may stay on their parents’ health insurance until they are 26 years old.

Many people who do not live at home or have finished their undergraduate degree will be affected by this bill, said David Orentlicher, law professor and co-director of IU-Purdue University Indianapolis’ William S. and Christine S. Hall Center for Law and Health.

“Your insurers now have to let you stay on your family plan whether you’re living at home, independent, married, undergraduate, graduate, Ph.D. student or unemployed,” Orentlicher said.

The only restriction on this provision is that those whose jobs offer affordable health insurance may not stay on their parents’ insurance, Orentlicher said.

Free preventitive care

Free preventive services, such as immunizations, will also take effect today.
“It’s very important,” Orentlicher said. “An ounce of prevention is worth a pound of cure.”

Orentlicher said financial barriers often lead to the contraction of illnesses that could have easily been prevented.

Prevention methods are often more effective and economical than treatments, Orentlicher said.

Daniel Beben, an IU Ph.D. student, said he believes health care reform is a positive change because people will seek prevention and treatments more often and will not rely on the emergency department.

Children with pre-existing conditions cannot be denied

Children used to be treated as adults by insurance companies, and adults could therefore be denied insurance for their children because of a condition or illness.

This is no longer legal.

“Up to 72,000 uninsured children are expected to gain coverage by banning insurers from refusing them coverage due to a pre-existing condition,” according to the release.

Choose your doctor

One of the concerns of health care reform was that people would not be able to choose their health care providers.

However, before the act was passed, it was legal for insurance companies to choose doctors for their policy holders, according to the White House press release.

Because of the act, policy holders must be allowed to choose their own doctor in their insurer network.

Ban on lifetime coverage limits

The ban of lifetime limits on insurance coverage for new plans will also take effect, according to the press release.

Orentlicher said many insurance companies cover patients only up to a certain point. For those with extended hospital stays, this can be a serious problem.

Currently, annual limits on insurance coverage are still legal, but they will be banned in 2014.

Guarantee a right to appeal

The White House said those denied coverage or those whose coverage had been restricted had few methods to appeal.

The federal government now guarantees that those with denied or limited coverage may appeal to a third party unconnected to the insurance company.

Unlimited emergency room visits

Before this act, insurers were able to choose what emergency rooms their policy holders could visit and were able to charge those who went to emergency rooms outside of a particular network.

The act prohibits this, according to The White House press release. New plans may not charge more for emergency services outside of a specific network.

Ban on recisions

The act will also ban insurance companies from lifting coverage after it has been purchased.

However, insurance companies are allowed to rescind coverage when the applicant has committed fraud.

Orentlicher said that some individuals claim insurance companies have accused their policyholders of fraud in order to avoid paying expensive hospital bills.

“Usually insurance regulations are by the state, so some states may not have those laws,” Orentlicher said. “Sometimes putting federal enforcement behind a law will make a difference in compliance.”

Beben said the act will benefit his family. His mother-in-law is a breast cancer survivor and is currently unemployed, so she has been denied insurance because of her previous condition.

“I supported it at first without knowing the details,” Beben said. “But I think it’s a good move.”