The Supreme Court upheld the constitutionality of the Affordable Care Act – the new health reform law. In the four years since this law was established, it has benefited millions of Michiganders by improving health care coverage and reducing costs. At the same time, the law’s most significant reforms have now taken effect, including the provision that will prevent private insurers from denying Americans coverage because of a preexisting condition or kicking them off their plan because they get sick.
To learn more about how Affordable Care Act works, I recommend watching this informative and entertaining 9-minute video from the Kaiser Family Foundation. Also, here are some answers to frequently asked questions about the law.
Below are some of the ways in which health reform has already benefited families in our state.
Consumer Rights and Protections
The Affordable Care Act puts consumers back in charge of their health care by establishing a “Patient’s Bill of Rights.” Insurance companies used to be able to take advantage of you by denying coverage to children who had asthma or were born with a heart defect, putting a lifetime cap on the amount of care they would pay for, or cancelling your coverage when you got sick or just by finding an accidental mistake in your paperwork. The Patient’s Bill of Rights protects you from these and other abusive practices. Here are some examples:
- End to Pre-Existing Condition Discrimination: Insurance companies can no longer deny coverage to children because of a pre-existing conditions like asthma and diabetes, providing peace of mind for parents of the more than 17.6 million children with pre-existing conditions. Starting in 2014, no American can be discriminated against due to a pre-existing condition.
- No more lifetime caps on benefits: In the past, some people with cancer or other chronic illnesses ran out of insurance coverage because their health care expenses reached a dollar limit imposed by their insurance company. Under the health care law, insurers can no longer impose lifetime dollar limits on essential health benefits and annual limits are being phased out by 2014. More than 105 million Americans no longer have lifetime limits thanks to the new law.
- End to Coverage Cancellations: Insurance companies can no longer drop your coverage when you get sick due to a mistake you made on your application.
More Affordable Coverage
The law can help you by bringing down health care costs and making sure your health care dollars are spent wisely. Insurance companies will now be accountable to their customers for how they are spending premium dollars, and how much they are raising rates. Plus, the new law will help lower costs through new tax credits and new marketplaces where insurers will have to compete for your business.
- Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. This means that 184,297 Michiganders with private insurance coverage benefited from $13,189,718 in refunds from insurance companies.
- Stopping Unreasonable Rate Increases: In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more.
- Small Business Tax Credits: Small businesses have long paid a premium price for health insurance – often 18 percent more than larger employers. The tax credit will benefit an estimated 2 million workers who get their insurance from an estimated 360,000 small employers who will receive the credit in 2011 alone.
Better Access to Care
The health care law builds on what works in our health care system. And it fixes what’s broken by providing you with more health insurance choices and better access to care.
- Affordable Insurance Marketplaces: Affordable Insurance Marketplaces are one-stop marketplaces where consumers can choose a private health insurance plan that fits their health needs. Starting in November 1, 2015, you can shop and apply for health insurance coverage through Michigan’s Health Insurance Marketplace. The open enrollment period ends February 31, 2015. To see if you are eligible for financial assistance to help make health insurance more affordable and sign up for updates, click here:
- Free Prevention Benefits: Insurers are now required to cover a number of recommended preventive services, such as cancer, diabetes and blood pressure screenings, without additional cost sharing such as copays or deductibles. Under the ACA, 76 million Americans with private health insurance gained preventive service coverage, at no out-of-pocket cost, including 2,518,000 Michiganders.
- Coverage for Young Adults: Under the law, most young adults who can’t get coverage through their jobs can stay on their parents’ plans until age 26 – a change that has already allowed 3.1 million young adults, including 94,000 young adults from Michigan, to get health coverage and given their families peace of mind.
The new health care reform law provides Medicare recipients with access to free preventive care and a free annual wellness visit every year. In 2012, 34.1 million seniors received one or more of these free services, including about one million individuals in Michigan.
People who hit the Medicare prescription drug “donut hole” are getting a discount on their prescription drugs. Since the health care law was enacted more than 8.2 million seniors and people with disabilities have saved a total of $11.5 billion on prescription drugs. That’s an average savings of about $1,407 per person since the health care law started closing the “donut hole.” In 2013, 178, 697 Michiganders saved over $188,248,200 on prescription drugs—an average of about $1,053 in savings per person. By 2020, the health reform law will eliminate the donut hole completely, ensuring that care is provided when you need it the most.
I am fighting to protect guaranteed benefits for all 47 million Americans on Medicare. Estimates by the Department of Health and Human Services indicate that the new benefits and services provided to Medicare recipients by the Affordable Care Act will save the typical senior over $3,500 over the next decade. The Affordable Care Act strengthens Medicare and extends the solvency of the Medicare Trust Fund —through 2030 by squeezing waste out of the system and making it more efficient, without reducing benefits.
- More on Improving and Protecting Medicare
Celebrating Medicare & Medicaid at 50
How Health Reform will affect you: Click here to learn more
Timeline of Implementation: Click here to Find out
Protecting Health Reform
Republicans in the House of Representatives failed in their efforts to repeal health reform in its entirety. They are now trying to repeal the bill in pieces, but they continue to be unsuccessful at undoing the substantial gains we have made. We need to support the gains we have made to make sure that health care is affordable and accessible for all Americans. You may review my statements here on their efforts to repeal a piece of the health reform law.
Health care research is essential to improving clinical treatments and finding new cures. I believe that we must provide adequate funding for medical and health research if we are to continue improving health outcomes and enhancing the quality of life in America. To this end, I strongly support increasing federal funds for the National Institutes of Health (NIH), the country’s top-notch federal agency for supporting and conducting research on disease prevention, causes, treatment, and cures.
I have urged for an increase in NIH funding to $32 billion for 2016 – this will enable our scientific researchers to continue to do the cutting edge research leading to cures for disease. In past years, I have strongly opposed the massive cuts proposed for NIH in the House Budgets. Democratic opposition was essential to preserving those funds.
In 2005, I introduced the Gynecologic Cancer Education and Awareness Act, which was signed into law in 2007. The bill is referred to as Johanna’s Law in honor of Johanna Silver Gordon, a Southfield high school teacher who died of ovarian cancer in 2000. The legislation created a federal education campaign to increase awareness and early detection of gynecological cancers. We continue to reauthorize this vital legislation in order to continue to fight against these deadly cancers. To view the website for the education campaign, housed at the Centers for Disease Control and Prevention, please click here.
I have been a strong supporter of our efforts to find cures and improve treatment for breast cancer. I joined other concerned members of Congress in writing the House Appropriations Committee to request that they provide robust funding next year for the Department of Defense peer-reviewed Breast Cancer Research Program.
The new health reform law provides women improved access to preventive services that can detect gynecological cancers early. To find out how the health reform law can help women and girls protect themselves from cancers, go here.
The health reform law removes barriers and discriminatory practices by insurance companies that hurt women. For a list of important changes for women in the new health law, go here.
The health care reform law also makes great strides for women by giving nursing mothers the right to reasonable accommodation to breastfeed at work, eliminating discrimination against women in health insurance plans and ensuring that women have the option to give birth in birth centers as well as in hospitals.
Child Development and Mental Health
According to the Surgeon General, only one-third of Americans with diagnosable mental illnesses like schizophrenia, bipolar disorder, and clinical depression are receiving appropriate treatment. This statistic tells me that we have a lot of work to do in the area of mental health care. I believe that all Americans should have access to mental healthcare when they need it, and I have made removing barriers to mental health treatment a top priority and why I supported mental health parity legislation.
(Updated March 23, 2015)