BEYOND THE NUMBERS
The House is expected to vote today, for the 37th time, to repeal part or all of health reform. Nevertheless, in the nearly two and a half years since the first such vote, health reform has made significant progress in achieving its basic goals: helping more Americans get affordable coverage, protecting consumers, and slowing cost growth across the health care system, both public and private.
Here’s a look at some of health reform’s accomplishments to date:
- Health insurance for millions of young adults. Before health reform, young adults were more likely to be uninsured than any other age group. To help address this problem, health reform requires insurers and employers that offer dependent coverage to allow parents to include children up to age 26 on their insurance plans. That’s a big reason why 3.1 million more young adults had health insurance in December 2011 than in September 2010, according to the Department of Health and Human Services (HHS).
- Free preventive care for tens of millions of Americans. Insurance companies now have to cover preventive care services at no charge, and Medicare provides preventive services without cost sharing, too. As a result, nearly 105 million Americans received free preventive health care in 2011 and 2012, according to HHS.
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.
- Protections for children and adults with serious illnesses. Health reform bars insurers 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, health reform’s ban on “lifetime limits” on health benefits means that people who get a serious illness 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.
- More affordable prescriptions for more than 6 million seniors. Health reform has begun to close the “doughnut hole,” the gap in Medicare prescription drug coverage that many seniors experience once their annual drug costs exceed $2,930.
Before health reform, seniors had no additional coverage until their costs hit about $6,600. Now, seniors receive a 52.5 percent discount on brand-name drugs and a 21 percent discount on generic prescription drugs while they are in the coverage gap.
More than 6 million Medicare beneficiaries have saved more than $6.1 billion as a result of these changes, according to HHS.
- Initial steps to help slow health care costs. Some of health reform’s cost-control provisions, such as cutting overpayments to the private insurance plans that participate in Medicare, are already producing savings. Other steps are underway to make the health care system more efficient by rewarding effective, high-value health care, although they may not yield results for several years.
For example, Medicare is cutting payments to hospitals with high readmission rates in order to encourage them to prevent more avoidable readmissions. Also, many physician-led “accountable care organizations” are up and running. These organizations are structured to encourage health care providers to take responsibility for the cost and quality of care they deliver, potentially reining in costs.