Congratulations! You’re One! It’s a big milestone for sure, and we all know it’s been a rocky one. Unfortunately, not everyone was excited about your passage, and like all big reform bills, you’re still growing. Hang in there! Despite the howls from some, there are a lot of folks who are rooting for you and can’t wait to see you grow up into the comprehensive act we envisioned.
Because of you, other newborns and infants now have coverage, and their moms and dads have more health care too, including family planning. Not to mention no more co-pays for cervical cancer screenings or mammograms. And no more gender discrimination! At least in insurance premiums (you’re only one bill). Plus, if you get sick, you can’t be kicked off your insurance plan. The benefits are rolling in. Let’s review some more:
- Insurers are banned from imposing lifetime dollar limits on coverage
- Insurers cannot charge higher costs for emergency services obtained outside of their network
- Insurers, including Medicaire, are required to cover a core set of preventive services without cost-sharing requirements such as co-pays, deductibles or co-insurance.
- Insurers must spend at least 80-85% of premium dollars on providing beneficiaries with health care and improving the quality of their care, and NOT on administrative costs and profits.
- Any insurers receiving federal funds will not be able to discriminate on the grounds of race, national origin, gender, age, or disability.
- Women may be eligible for premium and cost-sharing assistance if they purchase insurance through a health insurance exchange in the individual market.
- Insurers will be required to comply with limits on annual cost-sharing.
- Health plans are prohibited from denying coverage to children ages 0-19 with “pre-existing conditions” such as asthma and diabetes.
- 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.
You’ve even got a snazzy new website to help everyone navigate the new system. Not too shabby Lil ACA. With a little bit of luck and some help from your friends, I’m sure you’ll even weather the spending cuts and litigation. It won’t be easy, but as you get older and really come into your own, things will settle down. Your foes will get used to you, and many will even come to appreciate you. Hey, you’re here for everyone. So, have a slice of cake, make a little noisemaker noise, and sing yourself a hearty Happy Birthday. You’ve earned it!