Faith-based organizations such as the North Carolina Council of Churches were among the backers of healthcare reform, taking their cue from the biblical mandate to be our brothers’ (and sisters’) keepers.* Now, they are announcing the September 23rd starting date for provisions that should make families feel a bit more secure about their healthcare options.
In short, the NCC reports:
- Children under the age of 19 can no longer be denied coverage because of pre-existing conditions.
- Young adults up to age 26 can stay on their parents’ plan.
- Key preventive care will be covered without co-pays or deductibles.
- Insurance companies can no longer drop people from coverage when they become sick.
- Lifetime limits on insurance payouts will be eliminated; annual limits will be greatly restricted.
- Persons will have the right to external appeals of decisions made by insurers.
- Prior authorization for treatment cannot be required for emergency care; higher cost-sharing cannot be imposed for out-of-network emergency care.
- Women will have direct access to OB/GYNs without a referral.
- Enrollees in new plans must have a choice of primary care physicians. [source: NCC website. See link above]
President Obama signed the historic Affordable Care Act in March, 2010. Among its provisions also is a strengthening of Medicare, the program for senior citizens. Full details are available at http://www.healthcare.gov, but for now, here are the highlights, taken directly from the government’s website:
- “The life of the Medicare Trust fund will be extended to at least 2029, a 12-year extension as a result of reducing waste, fraud and abuse, and slowing cost growth in Medicare. This will provide you with future cost savings on your premiums and coinsurance.
- Medicare will take strong action to reduce payment errors, waste, fraud, and abuse in Medicare. The President has made a commitment to reduce Medicare fraud 50 percent by 2012. The Affordable Care Act makes an historic, ten-year, $350 million investment to prevent, detect and fight fraud in Medicare, Medicaid and the Children’s Health Insurance Program—including criminal efforts to exploit the new law. Visit Stop Medicare Fraud for more information.
- In 2011, if you hit the prescription drug donut hole, you will get a 50% discount on brand-name drugs. Every year after, you will pay less for your prescription drugs in the donut hole until there’s complete coverage of the donut hole in 2020. Between now and then, you will get continuous Medicare coverage for your prescription drugs.
- The coordination of care between doctors and the overall quality of care will improve so that you will be less likely to experience preventable and harmful re-admissions to the hospital for the same condition.
- Hospitals will have new, strong incentives to improve your quality of care.
- Starting in 2014, the Affordable Care Act offers additional protections for Medicare Advantage Plan members by taking strong steps that limit the amount these plans spend on administrative costs, insurance company profits, and things other than health care.”
* The NCC’s statement on healthcare reform: “As people of faith, we envision a society where each person is afforded health, wholeness, and human dignity. This vision embraces a system of health care that is: inclusive, accessible, affordable, and accountable.”