Confused About What Health Reform Has to Offer:
Sept. 23rd Marks One Year with New Patient Protections

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Obama signs the Patient Protection and Accountability Act, 2010

You may not love every single bit of health reform coming down the pike, but make no mistake about it: new patient protections that went into effect one year ago had their one-year anniversary Sept. 23. I think health reform, as enacted by the Patient Protection and Accountability Care Act (AKA “PPACA”), is a milestone for patients.

PPACA has a universal mandate, meaning that every American must have health insurance. If you’ve followed this issue, challenges to the law have been filed, but it is too early to tell how things will end.

I like the concept of a universal mandate and coverage because it brings us closer to everyone sharing the risk and financial cost of health care for all. Sure, I’d rather see something like single payer, but politically, I doubt that would fly at this moment. I admit that I am biased in favor of health reform and I did plenty of writing for a living that clarified health reform. So continue reading with that in mind.
PPACA Measures Enacted  Sept. 23, 2010


New patient protections that went into effect on Friday are good news. In comparison with where we were before, or where the right could move this issue, the public should applaud these changes. Consider these changes that went into effect on Friday:
1.    Insurers can no longer impose caps on essential benefits like hospital stays.
2.    Health plans cannot drop you when you get sick.
3.    Recommended preventive care, such as screening mammograms, colonoscopies, and vaccinations no longer require copays, coinsurance, or deductibles in all new insurance plans.
4.    Your health plan is more restricted in enforcing annual spending caps, but they will be completely eliminated by 2014.
5.    Individuals with Medicare Part D coverage get a $250 rebate, and 50% of the doughnut hole will be eliminated in 2011. By 2020, the doughnut hole will be eliminated.
6.    Prior authorization for emergency care and denial of out-of-network emergency care has been eliminated.
7.    Women can go directly to their ob/gyns without referrals.
8.    Lifetime limits on most policies are eliminated.
9.    An appeals process at health plans must be in place.

10. Dependents can remain on the parents’coverage until age 26.

My discussion of the law is far from comprehensive. There is plenty more.

It’s easy to feel blue when we hear potential nominees for President sit silently while a mob suggests an uninsured 31-year-old man die.

So I am taking a moment to pause so that we can remind ourselves what new patient protections health reform offers. If you have more to add, please put them up in comments and tweet them. Here’s a nice graphic of what becomes effective, when. Bookmark it, show it to skeptics. Challenges to health reform are often scary.

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6 Responses to Confused About What Health Reform Has to Offer:
Sept. 23rd Marks One Year with New Patient Protections

  1. LOrion says:

    Very good piece. Retired MD sending to D in 3rd yr Med School.

  2. Dolores Rogers says:

    We sorely need to be educated about the benefits of health reform accomplished to date. The loud attacks on any reform have obscured the particular patient rights that have been accomplished.
    Many thanks.

  3. aidel says:

    I fear that the small amount that has been accomplished here will be overshadowed by reactionary increases of costs by insurance companies. Obama, when he actually had the chance to accomplish something, did too much compromising and not enough ‘splainin to the public and acting.

  4. Blair Bolles says:

    This piece provides real information, so important that I am left wondering why I didn’t hear about it elsewhere. These changes are going to have to be recognized and welcomed if they are to survive the persistent Republican assault on them. The health care bill was the biggest legislation passed in a very long time and, except for the individual mandate, very few people seem to know what we’ve now got. Thanks for help putting out the word.

  5. EllenTK says:

    Thanks for this post. I’m about to go on Medicare and was planning to do the numbers to determine if I want Part D. I would have left out the $250 rebate if I hadn’t read about it here.

  6. Thank you, Laura. Spreading the risk, financial burden across the greatest number of Americans possible and lifting the health insurance albatross that’s around the necks of business owners and the self-employed so that they can compete on an even playing field with the rest of the developed world would solve a lot of other problems, too. We’re currently uninsured and hoping, soon, to be able join an affordable plan that provides more than just major medical with astronomical deductibles.

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