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Health reform offers substantial benefits to middle-class Americans, contrary to some recent claims. Here are some of the most important ones:
- A safety net for all. Insurers can no longer refuse to sell someone health coverage or charge higher premiums because of a pre-existing health condition. Health plans must now cover preventive care, such as vaccinations and routine screenings, with no cost sharing. Plans must also limit the amount they can require enrollees to pay out-of-pocket each year for covered benefits.
- Financial help buying insurance. People without access to affordable coverage from an employer can receive premium tax credits to help them buy insurance in the marketplaces. Credits are available to households with incomes up to 400 percent of the poverty level. That’s up to $95,000 a year for a family of four.
- No more job lock. Because health reform helps workers without access to affordable job-based coverage afford coverage on their own, workers no longer have to stay in or choose an otherwise less desirable job simply because it offers health coverage. They can start a business or retire early without worrying about access to health insurance. And losing a job no longer means losing health insurance.
- Health coverage for young adults. Parents whose insurance provides dependent coverage may now include children up to age 26 on their plans. As a result, more than 6 million additional young adults have enrolled in a parent’s health plan, 3 million of whom would otherwise be uninsured.
- Improving Medicare benefits. Health reform is gradually closing the prescription drug “donut hole,” the gap in coverage faced by beneficiaries with high drug costs. Last year alone, 3 million seniors and persons with disabilities saved $3.9 billion on their prescriptions — more than $900 per beneficiary. Health reform also eliminated cost-sharing charges for preventive health services (such as cancer screenings), and 37 million Medicare beneficiaries received at least one free preventive service last year.
- Strengthening Medicare financing. Health reform includes a number of measures to slow Medicare cost growth, such as cutting overpayments to private Medicare Advantage plans. These steps, along with other factors, have significantly strengthened Medicare’s financial outlook. Medicare’s Hospital Insurance (HI) trust fund is now projected to remain solvent 13 years longer than before health reform’s enactment. And the HI program’s projected 75-year shortfall has shrunk by three-quarters.
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