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Health Reform’s Six Month Anniversary

Hard to believe, but today marks the six-month anniversary of the passage of health reform.  We thought we’d take this opportunity to look at where things stand now. 

New Benefits
A bunch of new benefits in the Patient Protection Act are scheduled to take effect today.  Some of these benefits apply to every insurance plan.  Other changes apply to all plans except those policies that are exempted as “grandfathered” plans. The AARP has a pretty good explanation of grandfathered plans:

Grandfathered plans were already in existence on March 23, 2010, when health care reform became law, and are protected so that people who have them and are satisfied with their current coverage can keep it. These plans lose their exemption, however, if they significantly reduce benefits or raise members’ costs. You will receive a notice from your insurer if your plan is grandfathered. [For more on grandfathered plans, see here.]

Here are the Benefits that apply to all plans:

  • Young adults can remain on their family’s health plan until they turn 26. Although, as we pointed out in an earlier post, this is less straight-forward than it sounds.  Technically, the law states that for “plan years” starting after September 23, young adults can remain on their family’s health plan.  If, like many people, your plan year doesn’t start until January 1, then your adult child may have to wait until then to get back on your insurance.  Check with your employer or insurance company to find out for sure.
  • Plans can’t cancel coverage for people who get sick. By now, you’ve probably heard stories of people who had their coverage canceled by the insurance company when they got sick.   One man with lymphoma had his policy canceled because the insurance company discovered he had gallstones- even though his doctor had never discussed the condition with him. Another woman with breast cancer had her policy canceled when the insurance company discovered that she once had acne.
    That all changes starting now.  Insurance companies will still be able to screen for pre-existing conditions until the exchanges are up and running in 2014.  But once you get coverage, they can’t drop it when you get sick.
    • No more lifetime coverage limits. Also, if your plan was already canceled because you hit the lifetime limit, you’ll be able to rejoin the plan.

    Benefits that apply to all non-grandfathered plans:

    • Children up to the age of 19, can’t be denied coverage because of pre-existing conditions. Insurers are already trying to wriggle out of this one somewhat.  A number of major insurance companies have decided to stop selling policies for children, meaning that you cannot purchase a separate individual plan for your child.  They’ll still cover children, but only through a family plan.
    • Free immunizations for kids.
    • Free preventive care. Preventative services include things like screenings to detect diabetes, colorectal cancer, breast cancer, high blood pressure, high cholesterol and other problems. It also includes many vaccines- for example, this year most people will be able to get a flu shot without a copay.
    • Annual limits start to phase out. Three years from now, insurance plans won’t be allowed to set annual dollar limits on coverage, but this rule is getting phased in gradually.  For now, starting on September 23, insurance companies will have to cover annual medical expenses up to $750,000.

    Popularity and Politics

    The non partisan Kaiser Family Foundation has been tracking attitudes towards the health reform law since it passed.  You can see in the graph that over the spring and early summer the new law was gaining in popularity, but in the most recent poll the public opinion was evenly split.

    We’re not sure what’s caused the popularity of reform to drop, but a recent AP poll conducted by Stanford University and the Robert Wood Johnson Foundation might explain why it’s not more popular.  The poll found that a lot of people are still confused about what’s in the new law:

    • More than half of Americans mistakenly believe the overhaul will raise taxes for most people this year. But that would be true only if most people were devoted to indoor tanning, which got hit with a sales tax.
    • Many who wanted the health care system to be overhauled don’t realize that some provisions they cared about actually did make it in.
    • And about a quarter of supporters don’t understand that something no one wanted didn’t make it: They mistakenly say the law will set up panels of bureaucrats to make decisions about people’s care — what critics labeled “death panels.”  [The complete results from the survey are posted here.]

    The survey also included a quiz to determine how much people know about the new law.   The outcome was revealing:

    The poll’s questions included a true-or-false quiz on 19 items, some of which are in the law and others not. People were also asked how confident they were about their answers.  For the most part, majorities picked the right answers. But a sizable number also got things wrong. And right or wrong, people were unsure of their answers. Two-thirds or more were uncertain about their responses on eight of nine core provisions of the legislation.

    Here’s another interesting point from the poll: For Republicans, having accurate knowledge of the law made no difference- they tend to oppose it regardless.  But for Democrats and independents (who make up a majority of the population) the more accurate knowledge people had of the law, the more they liked it.  From the AP article:

    “Among Democrats and independents, the lack of knowledge is suppressing public approval of the bill,” said Stanford political science professor Jon Krosnick, who directed the university’s participation. “Although the president and others have done a great deal to educate people about what is in this bill, the process has not been particularly successful.”

    In other words, reform isn’t unpopular because people don’t like it– it’s unpopular because a lot of people still don’t know what’s in it.

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