Facts on the health care reform every American should know

Carol Forsloff - A senior citizen sat at the kitchen
table voicing her opinion on the health care legislation, but when
asked if she had read its provisions, she had not, like many Americans, but said she didn't like it anyway.  So here's an encapsulation of it.
But not liking something, one might
anticipate, should involve knowing it first.  The hue and cry against
the new health care bill was loud enough to drown most important pieces
of information that now change conditions that have caused Americans by
the thousands to be removed from insurance coverage or lose their life
savings because they couldn't pay medical bills.



In fact, it has been found that a
major cause of bankruptcy for seniors has been the high medical costs
that take place when there are catastrophic illnesses during the years
of aging.



But the woman at the table voiced
what many people in the senior group believe about the health care
bill:  that it requires death panels and takes away doctor choice as
well as significant coverage for Medicare.



The truth, however, is something
else.  To understand the health care bill might be important for both
those in favor of it and those not, so the Department of Health and
Human Services presents an overview for our
education.



The Patient's Bill of Rights is the integral part of the health care bill, so the story begins with it.



First of all, the Affordable Care
Act allows Americans with pre-existing conditions to have insurance
coverage and keep it.  It allows people to choose their own doctors and
removes lifetime limits on care.



What does this do specifically for
seniors?  Many have pre-existing conditions and before the Act could be
denied coverage by private insurers if they applied for coverage prior
to six months before qualifying for Medicare or after six months of
qualification.   Furthermore, once an individual reached the cap on
care, different on many policies but often at approximately $1 million,
then coverage ended.  This meant that long-term, serious diseases had to
be paid for out of pocket, taking people to bankruptcy.  Under the new
plan, this is no longer possible and the protections apply to nearly all
health insurance plans.





"After September 23, these rules
stop insurance companies from imposing pre-existing condition exclusions
on your children; prohibit insurers from rescinding or taking away your
coverage based on an unintentional mistake on an application; ban
insurers from setting lifetime limits on your coverage; and restrict
their use of annual limits on coverage." is a direct quote from the
Department of Health and Human Services.



Rather than not allowing an
individual to choose his or her own doctor, the new plan guarantees
choice .  Rather than insurance companies requiring individuals to have a
referral from a primary doctor before seeing a specialist, such as an
OB-GYN, an individual can choose to see a specialist independently.
Furthermore individuals will not have to get insurance permission before
seeking emergency care..



In addition, there are limits on
the insurance company's hikes of fees that put insurance out of the
reach and many Americans.  Insurers will have to publicly disclose their
rates on a national consumer website.



The plan also provides affordable
coverage to Americans without insurance due to pre-existing conditions.
Starting July 1, those Americans who haven't been able to purchase
insurance because of pre-existing conditions, can obtain affordable
insurance and have choices through exchanges, the same choices as
members of Congress.



Right now insurance companies can
arbitrarily cancel a policy when a person becomes sick.  Under the
Affordable Health Care plan they can no longer do that.

As
the DOH states, "Under the regulations, insurers and plans will be
prohibited from rescinding coverage – for individuals or groups of
people – except in cases involving fraud or an intentional
misrepresentation of material facts. Insurers and plans seeking to
rescind coverage must provide at least 30 days advance notice to give
people time to appeal. There are no exceptions to this policy."

The
specific value of older Americans is particularly highlighted by the
Department of Health, much of which began on September 23, the drumbeat
muffled by election protests.  But high medical costs that contribute to
more than half of the personal bankruptcies will be limited by the fact
that insurance companies can no longer deny or drop coverage nor place
ceilings on payments annually or lifetime costs.



Do most Americans know these
provisions.  Like the senior citizen at a kitchen table in Oregon, most
do not and instead repeat the talking heads responses, politically based
and biased.  The reality, however, is that new protections are provided
by the new plan that will help protect retirement savings from high
medical costs.



If knowledge is power, having the
knowledge about the new health care plan benefits is important,
particularly since new political candidates threaten to take it away.
Those opposing the health care plan have had large financial backing
from insurance carriers themselves.



For seniors good health care is a
value, because of the diseases of aging and concerns about savings at
vulnerable times when long term care is needed, where protection has been provided at least for health coverage that itself may be slashed as care program costs are increased.





Written by a journalist who read all 900 pages of the legislation at the time of its enactment.