New Health Care Provisions Begin to Pay Off for All Ages

Originally published on September 22, 2010 in Health Care and Tennessee Voices.

health care for allAs I sit beside my 92-year-old father in his hospital bed in Kingsport, Tennessee, there are reminders all around me of why I left my job in the insurance industry to become an advocate for health-care reform — and why all Americans have reasons to be grateful that many provisions of the reform bill that became law six months ago are taking effect now.

To begin with, there is my dad himself. He must take costly medications every day. This year he and millions of other older Americans fell into the Medicare Part D "doughnut hole." They have to spend thousands of dollars for medicines they need before their drug benefit will kick back in. The new law has already begun to reduce their pharmacy expenses.

The woman in the next room has breast cancer. She will no longer have to worry that her insurer might arbitrarily cancel her coverage.

One breast-cancer survivor told Congress last year that her insurer canceled her coverage because she had forgotten to note on her application that she had been treated for acne. Starting today, health plans will be banned from dropping people when they get sick, except in cases of fraud.

A young man down the hall is likely uninsured and will be on the hook for a big hospital bill. A large percentage of young people are uninsured because they can't afford premiums. Starting today, this young man will be able to stay on his parents' policy until he turns 26 if he doesn't have access to benefits where he works.

A local small-business owner whom a doctor introduced me to can't afford to offer benefits to his 25 employees. He and four million other small-business owners are now eligible for a tax credit of up to 35 percent of the cost of premiums. The number of small businesses offering health benefits fell from 61 percent in 1993 to 38 percent in 2008 because of rising premiums. The new law will help reverse that trend.

Several other important patient protections also go into effect today. Health plans will be prohibited from placing lifetime caps on benefits, and they will not be able to deny coverage to children because of pre-existing conditions. New health plans will be required to cover preventive services with no co-payments.

While I would have liked to see the final legislation include tighter restrictions on insurance premiums and the choice of a public health insurance option to promote greater competition, the new law is an important start that will ultimately benefit every American. It will protect us all from insurance industry practices that should have been outlawed or changed years ago.

For those who think the law should be repealed, I ask them to just stop and think how their loved ones might already be better off than they were six months ago -- and how much better off we all will be when the law has been fully implemented in 2014.

Wendell Potter, a former Cigna Corp. vice president, is a senior fellow at the Center for Media and Democracy.


Please keep in mind that these health care reforms are for individual or small group (less than 50 employees) health insurance policies, not large group or employer-sponsored health care coverage. This is an important distinction to be made. And, by the way, I like to call this Health INSURANCE Reform. Health care is the delivery of services which is doctors, nurses, hospitals, clinics, etc. Health insurance is a totally separate entity.

yes, but how about the BIG RATE INCREASES you will have to PAY!! and how about the BIG TAX INCREASES getting tacked onto a whole bunch of expenses.....????? AND, what about all the medicare fraud that's costing YOU BIG MONEY??? watch YOUR wages go down..down..down while everything else goes up..up..up !! YOU voted 'em in .. YOU now PAY!

Its not a easy road to travel when you have no wheels under your cart, Your not alone. As a person covered by Cigma I know the hurt to, take care of yourself, and your Dad.

Its not a easy road to travel when you have no wheels under your cart, Your not alone. As a person covered by Cigma I know the hurt to, take care of yourself, and your Dad.

As a nurse, I appreciate your comments about your father and others in similar positions. I agree that there are many reforms needed in our current health care system, including the reform of the insurance and pharmaceutical industries which contribute heavily to the high cost of health care. While both of these industries have changed their stance on health care reform and offered limited/qualified support of the new plan, much of this seems to be linked to self-interest and the desire to remain as key players in continued negotiations. Of particular interest is the recent (Oct 3rd) report in the Associated Press noting the lower rates of enrolllment in the Pre-Existing plan. It seems the higher premiums, requirements (6 months without insurance and documentation of refusal), and high deductible for pharmacy benefit are preventing many from taking advantage of the proposed benefits of this new plan.

Having a 35% tax credit for insurance for small businesses will help out a lot. This is awesome news for the small business owners and will definitely help out the economy. Now that more smaller companies can offer health insurance there will be more over all coverage.

We can all find cases and prob­lems with any health-care sys­tem regard­less of who tries to imple­ment it. How­ever, I know from per­sonal expe­ri­ence that this health-care sys­tem is good for the mid­dle class.