Happy Birthday Health Reform, Part 1: A Look Back

Two years ago today, President Obama signed the Affordable Care Act — health reform — into law.  Millions of Americans already are experiencing the benefits, and other important parts of the law are starting to move forward.  This series of posts will look at what health reform has accomplished and what it will accomplish over the next few years, as well as certain issues related to health reform.

First, a look back at health reform’s achievements in its first two years:

1. Prescription drugs are more affordable for 5.1 million seniors and people with disabilities.
   Health reform has begun to close the “doughnut hole,” the gap in Medicare prescription drug coverage that many seniors experienced once their annual drug costs exceeded $2,840.  Before health reform, seniors had no additional coverage until their costs hit $6,448.

   Last year, seniors received a 50 percent discount on brand-name drugs and a 7 percent discount on generic prescription drugs while they were in the coverage gap.  This year, the generic discount jumps to 14 percent.

   5.1 million Medicare beneficiaries have saved more than $3.2 billion as a result of these changes, according to the Department of Health and Human Services (HHS).   The law will close the entire doughnut hole by 2020.

2. Two and a half million young adults have gained health insurance.
   Health reform requires insurers and employers that offer dependent coverage to allow parents to include children up to age 26 on their insurance plans.  As a result, 2.5 million more young adults had health insurance in June 2011 than in September 2010, according to HHS.

   In the past, most insurance companies dropped children once they turned 19 or a few years later if they were students.  That’s one reason why nearly a third of all young adults lacked insurance in 2010 — a larger share than any other age group.

3. Tens of millions of Americans are getting free preventive care.
   Insurance companies now have to cover preventive care services at no charge, and Medicare provides preventive services for free now, too.  As a result, nearly 87 million Americans received a free preventive health care service last year, according to HHS:  54 million through private insurance and 32.5 million through Medicare.

   Preventive care includes screenings for chronic illnesses like diabetes and cancer, routine vaccines for adults and children, and other recommended care for kids, such as 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.

4. Insurance companies can no longer deny coverage to sick children.
   Health reform 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.

   This rule will apply to adults, too, starting in 2014.

5. Insurance companies can no longer cut off care for people who need expensive medical care.
   Health reform 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 expensive treatments will push them into bankruptcy — or worse, that coverage limits will prevent them from getting lifesaving care.

   HHS estimates that before health reform, 105 million Americans had insurance plans with lifetime limits.

Next up: a look ahead at some of health reform’s major benefits that are still in the works.