It’s In The Law: Breaking Down What’s In It For You in the New Health Care Law

by Thao Nguyen, National Women’s Law Center

Greater protections against insurance company abuses:

  • NO MORE RESCISSIONS: Insurance companies are prohibited from dropping your coverage if you become sick.
  • NO MORE LIFETIME LIMITS: Insurance companies are prohibited from limiting the amount of money they will pay for your benefits over your lifetime.
  • NO MORE ANNUAL CAPS: Insurance companies are prohibited from limiting the amount of money they will pay for benefits during one year. During 2011, annual limits cannot be lower than $750,000 & are completely prohibited by 2014.
  • NO MORE DOCTOR’S NOTE TO VISIT THE OB-GYN: The new health care law allows women to have “direct access” to this type of health care. Insurance companies are prohibited from requiring women to get referrals from their doctor for obstetrical & gynecological care.

Improved access to affordable preventive care.

All new health plans are required to cover key preventive health services for women at no additional cost, such as co-payments or deductibles.

Preventive services that many plans started providing women and girls, starting January 1, 2011:

  • Mammograms every 1-2 years for women over 40
  • Cervical cancer screening
  • Smoking & alcohol cessation programs for adults
  • A wide range of prenatal screenings & tests
  • Diabetes & blood pressure screening & counseling
  • Depression screening for teens & adults.

Added to this list are the newly announced preventive services for women, starting on August 1, 2012, including:

  • All FDA-approved contraception
  • Well-woman visits
  • Lactation consultation & supplies
  • Screening & counseling for interpersonal & domestic violence
  • Screening for gestational diabetes
  • DNA co-testing for HPV
  • Counseling regarding sexually transmitted infections, including HIV
  • Screening for HIV

Senior women have more affordable access to the services they need:

  • Medicare now covers more preventive benefits such as no-cost annual checkups and mammograms.
  • The Medicare Part D “donut hole” closing. Last year, seniors in the donut hole, or the prescription drug coverage gap that requires seniors to pay the entire cost of prescriptions while in the gap, received rebate checks; this year, they will receive 50% discounts on brand name drugs.

It is now easier for children & young adults to get & keep health insurance.

  • Young adults can remain on their parents’ health insurance policy until age 26.
  • Health plans are prohibited from denying coverage to children (aged 19 & under) with “pre-existing conditions” such as asthma or diabetes.

Additional important provisions for women that are in place:

  • A new tax credit that helps small businesses provide coverage to their employees. Women are more likely than men to work for small businesses that don’t offer health insurance.
  • A requirement that employers with more than 50 employees provide women a reasonable time and place to express breast milk.
  • Access to a new pre-existing condition insurance plan – or “high-risk pool” – that is available to women who are uninsured due to a preexisting condition until 2014, when insurance companies will no longer be able to deny women coverage due to pre-existing conditions.

This is just the beginning. In 2014:

  • Insurance companies will no longer be able to deny women coverage due to pre-existing conditions, such as having had a C-section, breast or cervical cancer, or received medical treatment for domestic or sexual violence.
  • Insurers must end the practice of charging women more for health insurance than they charge men.
  • Approximately 10.3 million uninsured women will gain health coverage from expanded Medicaid eligibility.
  • Up to 7 million women who lack affordable insurance through an employer will be eligible for subsidies to help pay for health coverage.
  • A new competitive marketplace will be available for women and their families to compare & shop for new health plans.

This blog is part of the #HERvotes blog carnival.

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