My 8-year-old son is a leukemia survivor. He was diagnosed with leukemia when he was 3 years old. He underwent three years of chemotherapy and has been off treatment since June, 2010.
We were fortunate to have had good insurance through my husband's employer when our son got sick. However, a couple of years later, my husband was laid off from his job. In the time since then, he worked as a sole proprietor of his own business for a while and is now working for a company that does not offer health insurance. In both cases, our family needed to purchase insurance on the individual market.
Prior to the Affordable Care Act, I was told by every insurance broker who I spoke with that no insurance company would sell us coverage for our son because of his pre-existing condition. He was considered "uninsurable" until he had been off treatment for at least five years. They said that they could sell us a policy for the rest of the family, but not for him. So we went on COBRA in order to continue our insurance coverage, but that only lasts for 18 months.
I started checking into buying insurance on the individual market again when we were getting closer to the end of our 18 months of COBRA coverage. By that time, the part of the Affordable Care Act that guarantees coverage for children with pre-existing conditions had already gone into effect. Because of this, we were able to buy a family policy that would cover our son, regardless of his pre-existing condition. I am so grateful for the Affordable Care Act because my son has health insurance today because of it.
Here's a list of some of what's happened because of the Affordable Care Act (health reform) already:
• Eliminating Lifetime Limits on Insurance Coverage. Under the law, insurance companies will be prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays.
• Prohibiting Denying Coverage of Children Based on Pre-Existing Conditions. The health care law includes new rules to prevent insurance companies from denying coverage to children under the age of 19 due to a pre-existing condition.
• Providing Free Preventive Care. All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.
• Extending Coverage for Young Adults. Under the law, young adults will be allowed to stay on their parents' plan until they turn 26 years old (in the case of existing group health plans, this right does not apply if the young adult is offered insurance at work).
• Providing Small Business Health Insurance Tax Credits. Up to 4 million small businesses are eligible for tax credits to help them provide insurance benefits to their workers. The first phase of this provision provides a credit worth up to 35% of the employer's contribution to the employees' health insurance. Small non-profit organizations may receive up to a 25% credit.
• Bringing Down Health Care Premiums. To ensure premium dollars are spent primarily on health care, the law generally requires that at least 85% of all premium dollars collected by insurance companies for large employer plans are spent on health care services and health care quality improvement. For plans sold to individuals and small employers, at least 80% of the premium must be spent on benefits and quality improvement. If insurance companies do not meet these goals, because their administrative costs or profits are too high, they must provide rebates to consumers.
This blog comes from MomsRising.org and CustomFitWorkplace.org and presents innovative ideas to strengthen 21st Century American families through public policy, business practice, and cultural change.