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Affordable Care Act at Six Months

This week marked the six month anniversary of the passage of the health care reform law. Many events have taken place over the past week to highlight the new law.  We were also reminded of the great need for reform, newly released 2009 Census data shows that 50.7 million individuals went without health insurance this year, 10% more than in 2008.
As you know HFA was heavily involved in advocating to make sure needs of individuals with bleeding disorders were addressed in Affordable Care.  At the six month mark HFA is still involved in highlighting the benefits of healthcare reform and the need for effective implementation. HFA President Paul Brayshaw hosted President Barack Obama’s Backyard Health Care Policy Forum at his home is Falls Church, VA (read HFA’s press release) and Public Policy Director, Kisa Carter was invited to participate in a series of blogs on the Families USA website Stand Up For Health Care.
The new healthcare reform has afforded many in our community with new rights and benefits. Parents will be able to kept their children on their family policy until the age of 26 or until they receive coverage through an employer. Small businesses will receive tax credits to help provide financial resources to cover the cost of health insurance premiums. Insurance companies can no longer discriminate against children with pre- existing conditions and they cannot rescind your policy if you get sick.  You will no longer have to pay deductibles or other costs sharing fees for preventative doctor visits and child immunizations.  Insurance companies can no longer place lifetime limits on plans and are restricted on the annual dollar limits that may place on a plan, with the eventual elimination of annual limits in 2014. Patients will also have direct access to pediatricians, gynecologists and obstetricians, without the need of a referral from a primary care physician.  If you’re experiencing a medical emergency you will no longer pay higher co-pay or higher co-insurance rates for out of network emergency services. Healthcare reform also directs insurers to create a consumer friendly appeals process for medical claims disputes.
With all of these new benefits and those yet to be implemented, there are challenges that lie ahead.  Many states do not have the systems in place to handle the large amount of eligibility determinations needed to enroll individuals in health insurance.  States will not only have to determine if individuals are eligible for Medicaid but for other types of insurance programs as well.  States will need systems that can efficiently determine eligibility and be designed so that the process does not become burdensome for the applicant. The federal government is prepared to provide administrative and financial resources to states, but it is still not clear if this can by 2014 when all individuals are mandated to have health insurance. Also many of the federal regulations geared toward the insurance industry have not been released, making it difficult to estimate the total impact health care reform will have on insurance premiums or how the insurance market will respond.  We are already seeing some insurers deciding to not offer “child only” health insurance policies, after being required by health care reform to cover all children regardless of health status.
State level advocacy is key to effective health care reform implementation. Please see the recent blog regarding the Center for American Progress to read how you can stay engaged in the process.
For more information on the Affordable Care Act visit the federal government’s informational website: http://www.healthcare.gov/law/introduction/index.html
Hemophilia Federation of America: https://hemophiliafed.org/advocacy/advocacy-in-a-box/
Families USA: www.familiesusa.org

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