BEYOND THE NUMBERS
The House of Representatives plans to vote tomorrow on a bill to repeal the Affordable Care Act — that is, health reform. Below are five of its provisions that are already having an impact. As the list shows, repealing health reform would make it harder for many Americans to get insurance, harder for families and seniors with coverage to afford the care they need, and harder for small businesses to provide insurance for their employees:
1. Insurance coverage for young adults. The Affordable Care Act requires insurers and employers that offer dependent coverage to allow parents to include children up to age 26 on their insurance plans. This year alone, 1.25 million young adults are expected to benefit. In the past, most insurance companies dropped children once they turned 19 or if they weren’t students. That’s one reason why a third of all young adults lack insurance — a larger share than any other age group.
2. Free preventive care. Forty-two million seniors in Medicare and another roughly 41 million Americans with private insurance can now get free preventive health care services because the Affordable Care Act requires insurers to provide it. Preventive care includes screenings for chronic illnesses like diabetes and cancer, vaccinations, and regular doctor visits. Better access to preventive care will help millions of families with their budgets and likely produce other benefits, such as fewer unnecessary deaths from disease, less spending on costly and avoidable illnesses, and a healthier population overall.
3. Protections for children and adults with serious illnesses. The Affordable Care Act bars insurance companies from denying coverage to children with pre-existing health conditions like cancer, autism, or diabetes. As a result, for the first time in most states, families with children with serious illnesses, chronic conditions, or special health care needs can buy coverage for their children in the individual health insurance market.
Also, insurers can no longer cut off care for people with serious illnesses who need expensive medical care. The Affordable Care Act bars insurers from imposing “lifetime limits” on benefits. Now, people who get cancer or another illness that requires expensive treatments won’t have to worry that their benefits will run out or that the expensive treatments will push them into bankruptcy — or worse, that coverage limits will prevent them from getting lifesaving care.
4. More affordable prescriptions for seniors. The Affordable Care Act has begun to close the “doughnut hole,” the gap in Medicare prescription drug coverage that many seniors experience for drug costs beyond their first $2,840 but before additional coverage kicks in when their costs hit $6,448.
Before the Affordable Care Act, seniors paid 100 percent of prescription drug costs within the doughnut hole. Last year, seniors received a $250 payment under the Affordable Care Act to help with these costs. This year, seniors are getting even more help — a 50 percent discount on brand-name prescription drugs and a 7 percent discount on generic prescription drugs while they are in the coverage gap. The law will close the entire doughnut hole by 2020.
5. Tax credits to help small businesses buy coverage for their employees. Starting last year, an estimated 4 million small businesses, covering as many as 16.6 million employees, became eligible for a tax credit under the Affordable Care Act to help offset the cost of buying health coverage. It costs small businesses much more than larger firms to provide health insurance with comparable benefits, both because they have higher administrative costs and because small businesses with older or sicker workers pay higher premiums. The tax credit will help small businesses that are struggling to provide coverage to their workers and encourage more small businesses to offer coverage.
More improvements to the nation’s health care system will take effect in the months and years ahead. Tomorrow, we’ll look at five important benefits of the Affordable Care Act that won’t take effect if health reform is repealed.