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The Affordable Care Act (ACA) contains important insurance reforms that benefit consumers now and in 2014. These consumer protections will end the insurance companies’ stranglehold on our health care and guarantee that individuals can get affordable coverage, even if they are sick.
Reforms in Place Today
Free preventive care. Insurers must cover effective, cost-saving preventive care at no cost. For a list of covered services, including covered services for women, click here.
- No lifetime limits on your coverage. Annual limit restrictions are being lifted gradually and will disappear in 2014.
- Coverage for young adults. Young adults can stay on their parents’ health insurance until age 26. This provision covered 2.5 million young adults and has increased the rate of private insurance for young adults by more than 50%.
- No rescissions. Insurance companies can no longer cancel your health insurance policy just because you get sick. Insurers used this practice, known as rescission, after searching for some minor inconsistency in your insurance application (like misstating your weight or not disclosing teenage acne) to retroactively cancel your health insurance and deny your medical claims.
- No coverage denials for children. Insurance companies are not able to deny children coverage because of pre-existing conditions.
- Access to emergency room services. Insurers will no longer be able to require prior authorization for emergency care or charge excessive copays for out-of-network emergency room care.
- Additional reforms are keeping health insurance premiums in check and ensuring that health insurance companies spend at least 80% of your premium on medical care.
Reforms Launching in 2014
- A new health insurance marketplace. The health insurance exchanges will be state-based marketplaces for comparing and buying insurance. Read more on exchanges here.
- No pre-existing condition exclusions. Insurers will no longer be able to deny health insurance to the 129 million people in the U.S. with a pre-existing condition. They also can’t discriminate against women who are victims of domestic violence.
- Fair premiums. Insurers can’t raise your premium because you get sick or charge you higher premiums for being a woman, and variation based on age will be limited.
- Guaranteed issue and renewability. Insurers cannot turn you down for any reason and, as long as you pay you premiums, they have to give you an opportunity to reenroll in your plan.
HCAN’s Work on Insurance Reforms
In the field, HCAN regularly educates members of the public on these important reforms. We work with senior centers, churches, community centers, union halls and other groups to make sure everyone knows about the provisions of the ACA that are already in place and those that are coming in 2014.
- HCAN’s comments on these regulatory proposals
- HCAN medical loss ratio materials
- HCAN health exchange materials
- Herndon Alliance fact sheet on health exchanges
- A timeline for the implementation of all the insurance reforms
- All HCAN materials on insurance reform