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Access to Care

Quick Facts

  • Over 32 million currently uninsured Americans will gain health coverage through the Affordable Care Act (ACA).
  • The new Patient’s Bill of Rights eliminates lifetime limits, arbitrary rescissions of coverage, and pre-existing condition exclusions for children under 19.
  • Young adults can now remain on their family’s healthcare plan up to the age of 26.
  • The ACA allocates $5 billion in financial assistance to employers to help them maintain coverage for early retirees between the ages of 55 and 65.
  • Beginning in 2014, tax credits will be available for people under age 65 who purchase coverage on their own in a Health Insurance Exchange and are not covered through their employer, Medicare or Medicaid. Try out the Health Reform Subsidy Calculator.

 

The Challenge

Currently, nearly 50 million Americans do not have health insurance. Most of these people are working but their jobs do not provide health insurance and they can’t afford coverage on their own because insurance companies charge individuals more than they charge companies. Additionally, many insurers deny applicants with pre-existing medical conditions and impose lifetime limits on their coverage plans. With so many insurance companies choosing to put their financial interest before the patient’s well-being, thousands of Americans cannot get the preventive care or the medicines that they need. People suffering from chronic diseases like high blood pressure, diabetes, and lung disease are hardest hit by the soaring costs of individual coverage. Their dilemma only increases with age; the percentage of large firms providing workers with retiree coverage has dropped from 66 percent in 1988 to 31 percent in 2008. Every day, thousands of Americans wait too long to see a doctor because they don't have insurance—and 45,000 people die each year because of it.

The Opportunity

With the Affordable Care Act (ACA), we have the opportunity to create a more effective healthcare system that provides Americans with more accessible and effective coverage. Overall, the new health reform law will expand coverage to 32 million Americans who are currently living without health insurance.

The Departments of Health and Human Services (HHS), Labor, and Treasury have already started to implement some of the reforms called for in ACA, such as a new Patient’s Bill of Rights that will eliminate pre-existing condition exclusions for children under 19. The Patient’s Bill of Rights will also prohibit insurance companies from arbitrarily rescinding coverage (except in cases involving fraud) and from including lifetime limits in health plans. Additionally, the Department of Health and Human Services (HHS) announced in July 2010 that uninsured individuals could begin applying to be a part of a national high-risk pool that provides health coverage to people with pre-existing medical conditions.

The Departments of HHS, Labor, and Treasury have also issued a new coverage option for young adults that will allow dependents to remain on their family’s health coverage plan up to the age of 26.

Finally, the Department of HHS has established the Early Retiree Reinsurance Program to address the growing problem of retirees who lack employer-sponsored insurance but are not yet eligible for Medicare. This program will make it easier for employers to provide coverage to early retirees by providing reimbursements of up to 80% on claim costs for health benefits between $15,000 and $90,000. Although the program is only a temporary solution—it ends on January 1, 2014—it is an essential step toward providing all people living on a fixed income with affordable health coverage.

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