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Health insurance: progress report on the Affordable Care Act

We are coming up to the two year mark since the Affordable Care Act was signed into law. It was a bitter fight to prevent its passing and the fight has not stopped as the cases make their way through the courts to the Supreme Court. But, despite the controversy, the first steps towards implementation are under way. So, as we come closer to the next Presidential Election, itís time to review progress to date. That way, you can have a summary of the facts rather than political ads and stump speeches to guide you.

One of the age groups most at risk has been the young adults, i.e. those in the range of nineteen to twenty-five. In part this has been because their health tends to be good and the young are always optimistic about their chances of surviving without problems until middle age. The rule change that allows this group to stay on their parentsí plans until twenty-six has saved more than one-million from the ranks of the uninsured. More importantly, more than thirty-thousand who were previously refused cover because of a pre-existing condition have now been insured. This is one of the protections in the Patientís Bill of Rights alongside the equally powerful rule insurers can no longer cap the total amount of cover over your lifetime. If you develop a chronic problem you need no longer live in fear your insurance cover will run out.

More generally, the shift of emphasis to more preventive care is already showing good results. The earlier you get a diagnosis of a serious problem, the better the chances of a quick cure. So long as hospitals wait for you to turn up in the ER with life-threatening symptoms, the survival rates are moderate to poor. More than twenty million people have so far been through one of the preventive services without charge. The rules prevent insurers from requiring co-payments or cost-sharing on all preventive services. Thereís also a better distribution of care with more doctors being drafted in to serve the rural areas with clinics opening prepared to offer care to those in need regardless whether they are insured.

Finally, Big Government is increasing funding to all states to provide the expertise to vet all the applications made for premium rate increases. All applications for more than a 10% increase have to be justified and the information posted online. So far, states have grown more protective of policyholders with many rate increases refused or scaled back. Transparency from the insurance industry is a novelty but, so long as we get the benefits, itís a good thing. This goes alongside a new rule requiring insurers to spend not less than 80% of their revenue on providing health care services. If any company is found to break this rule, it will have to pay a refund to all policyholders.

So the benefits are already working their way through the system and should already be showing up in your health insurance quotes . Even those on Medicare are saving 50% on prescription drugs thanks to a closing of the donut hole. This means better health care is now increasingly available and, while it may not be cheap health insurance, holding down rate increases is keeping insurance affordable.


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