Kathleen Sebelius: Health care reform helps many

  • Article by: KATHLEEN SEBELIUS
  • Updated: March 22, 2012 - 9:08 PM

On the anniversary of the Affordable Care Act, let's review its benefits.

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Health and Human Services Secretary Kathleen Sebelius

Photo: Susan Walsh, Associated Press

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Today I'm in Minneapolis to mark the two-year anniversary of the Affordable Care Act. Since the law took effect, millions of families across the country have started to see its benefits in their lives. Some of the biggest changes are new protections that are forcing insurance companies to play by a fair set of rules.

The first big improvement is a new Patients' Bill of Rights that outlaws some of the insurance industry's worst abuses. In the past, insurers could take advantage of you. They could put a lifetime cap on the amount of care they would pay for, a back-door way of denying care to people with chronic illnesses or diseases like cancer.

Even worse, insurers could cancel your coverage after you got sick just by finding an accidental mistake in your paperwork. Some insurance companies even used computer programs designed specifically to search the records of people with breast cancer looking for these errors. Now, these practices are illegal, giving hard-working families some peace of mind. More than 105 million Americans are benefiting from the ban on lifetime dollar limits alone.

One of those Americans is Abby, a University of Minnesota student with a rare congenital parasitic disease. Access to world-class doctors and care has helped Abby maintain stable health. But she has always lived with the fear that coverage limits would put the care she needs beyond her reach. Not anymore, thanks to the law.

Getting rid of these abuses was long-overdue. But perhaps the biggest difference since the act's passage is the new protection for the 129 million Americans with preexisting conditions, from high blood pressure and asthma to autism and diabetes.

In the past, insurance companies could hike their rates, carve out the benefits they needed and, in many cases, lock these people out of the insurance market altogether. For people with potentially fatal conditions like cancer, this often meant being unable to afford the treatments that could save their lives.

Now, through the law's Pre-Existing Condition Insurance Plans, tens of thousands of Americans who had been shut out of the market are getting the health insurance they need. And it is also now illegal to deny coverage to a child because of a preexisting condition, a protection that will extend to all Americans in 2014.

The law is also making sure that people's insurance actually covers the care they need. We know that treating health problems caught early is much more effective and less expensive than treating those caught later. Yet in the past, many insurance plans didn't cover preventive care like diabetes screening, tobacco-cessation counseling, and mammograms. Or if they did cover it, they charged expensive copays and deductibles that put it out of reach for many families.

That's changing now that the law is requiring that many plans cover preventive benefits with no out-of-pocket costs. Last year, 54 million Americans with private health insurance and another 32 million seniors and people with disabilities on Medicare gained access to free recommended preventive care from cancer screenings to vaccinations thanks to this provision.

Finally, the law is demanding transparency and accountability for the insurance industry when it comes to hiking your premiums. For example, most insurance companies must spend at least 80 percent of your premium dollars on health care -- not on overhead and CEO salaries. If they don't, they have to send you a rebate. And they can no longer raise your premiums by 10 percent or more with no accountability.

Thanks to the health care law, the health insurance market is no longer stacked in favor of big insurance companies. Instead, consumers like Abby are getting more control of their health care. And millions of Americans who have been locked out of the market or have lived in fear of losing their coverage are gaining access to the care they need to stay healthy and thrive.

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Kathleen Sebelius is secretary of the U.S. Department of Health and Human Services.

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