September 25, 2010 12:24 AM UTC

Health Reform Improving Lives of Coloradans

•  
• by: CCHI

( – promoted by Colorado Pols)

September 23rd Provisions Bring Consumers Accountability, Fairness, Security

Dede de Percin, Colorado Consumer Health Initiative

For years Coloradans have lived with uncertainty about their health insurance- lifetime caps, recissions, coverage for life-saving screenings.  New provisions that begin on September 23rd, the 6-month anniversary of the signing of the Affordable Care Act, address some of the biggest concerns consumers had about the failing health system.  

These new requirements will help transform worry about coverage into stability, security, and peace of mind for health care consumers.

As of September 23rd, new and renewing health insurance policies must:

Stop Dropping Policyholders

Up until the Affordable Care Act, bottom-line obsessed insurance companies routinely cancel individual coverage of policyholders diagnosed with a serious and expensive disease like cancer.  Congressional hearing testimony in 2009 revealed that three major carriers canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.  Employees at these companies were praised in performance reviews for terminating the policies of customers with expensive illnesses.

The National Association of Insurance Commissioners cites an average of 3.7 “recissions” (or insured people dropped after they get sick) per 1,000 policies.  Since 345,000 individuals purchase insurance in the individual market in Colorado, about 1,300 of our insured friends or family members were at-risk of being dropped from the coverage they think will protect them during an illness.

Eliminate Lifetime Insurance Limits

What a relief to know that your insurance will be there for as long as you need it if you are involved in an accident or become sick.  Beginning September 23rd health insurance companies will no longer be allowed to place lifetime limits on how much they pay out to cover claims.

This will bring great peace of mind to the Wilkes family, whose seven-year old son Thomas was born with hemophilia.  As a co-founder of a telecommunications company, father Nathan was shocked when his company’s insurer raised the price for the entire group of 120 employees to compensate for Thomas’ treatments, and instituted a brand-new $1 million cap on coverage, which the boy exceeded in just over one year.  Within another year, he burned through the state’s “last resort” insurer CoverColorado’s $1 million cap. At that point, a social worker suggested Nathan and his wife divorce so their son could qualify for Medicaid. That’s just wrong.    

Extend Coverage to Young Adults to Age 26

Colorado families and young adults will feel more secure that dependent health care coverage will cover children up to age 26 starting September 23rd.  This will affect as many as 18,600 young adults in Colorado and 1.64 million young adults nationwide, regardless of tax dependence or independence, student, employed or married.  “Grandfathered” plans can exclude this coverage, but only until 2014.

This health care security is a relief to CSU environmental policy graduate student David Taft, who now is able to pursue internships in his field that provide great job experiences but don’t offer health care coverage.  “I am so relieved I can stay on my parents’ health care plan so I can concentrate on learning at my sustainable development internship to prepare for my future career.”

Provide Affordable Preventive Care

An ounce of prevention is worth a pound of cure. Regular and recommended screenings for diseases such as breast and prostate cancer, as well as essential health services, such as immunizations – save lives and money, and improve quality of life, stability of families, and productivity at work.  Policyholders will benefit from affordable preventive care, as insurers will be required to provide coverage for critical services such as immunizations or mammograms without charging co-pays or other forms of cost sharing.

There were literally hundreds of changes to the health system that took affect on March 23rd, the day the Affordable Care Act was signed into law.  In the past six months, we’ve seen additional reforms implemented, such as the federal high-risk pool and funding to help increase the Division of Insurance’s capacity to review health insurance premium rate increase filings.  

September 23rd is another big milestone in health reform, as these new provisions will help ensure healthier kids, families, and individuals in communities throughout Colorado. That’s the peace of mind we need and deserve.

Dede de Percin is the Colorado Consumer Health Initiative executive director.  CCHI’s membership includes over 60 statewide nonprofit organizations representing well over a million Colorado consumers of health care.