Passed more than two and a half years ago, the massive health reform law has already triggered major changes. Here are some of the most significant measures that began taking effect in 2010:
Adult dependent insurance coverage to age 26. Adult children up to age 26 can now continue to get health insurance on their parent's policies. A report earlier this year from the Commonwealth Fund estimated that 13.7 million persons aged 19 to 25 stayed on or joined their parents' health plans last year, and that 6.6 million of them would not have been eligible to do so without this provision of the law. This increase was a major reason why the number of Americans without health insurance dropped last year for the first time in four years.
End of lifetime limits on insurance payouts. The impact of this change won't be felt for a long time by most people, but the government projects that 105 million Americans now no longer worry that their coverage will run out. "While some plans provided coverage without dollar limits on lifetime benefits, 105 million Americans were previously in health plans that had lifetime limits," the U.S. Department of Health and Human Services (HHS) said earlier this year. "HHS estimates that 70 million people in large employer plans, 25 million people in small employer plans, and 10 million people with individually purchased health insurance had lifetime limits on their health benefits prior to the passage of the Affordable Care Act." The law also restricts annual coverage limits and will phase them out as follows:
- $750,000: for a plan year or policy year starting on or after September 23, 2010 but before September 23, 2011.
- $1.25 million: for a plan year or policy year starting on or after September 23, 2011 but before September 23, 2012.
- $2 million: for a plan year or policy year starting on or after September 23, 2012 but before January 1, 2014.
- No annual dollar limits are allowed on most covered benefits beginning on January 1, 2014.
End of pre-existing restrictions on children's access to health insurance. The law has ended insurance denials based on pre-existing conditions for an estimated 17.6 million children under age 19. These changes are part of an extensive set of 2010 consumer safeguards that the government called a "Patient's Bill of Rights."
Expanded coverage of preventive benefits. People under age 65 who are covered by private health insurance received a range of free wellness benefits. Earlier this year, HHS estimated that about 54 million people had received preventive health benefits without cost-sharing. Here's an HHS summary of what is now available (women's preventive benefits were further expanded in 2012 and will be covered in a later part of this series):
Children (0-17): Coverage includes regular pediatrician visits, vision and hearing screenings, developmental assessments, immunizations, and screening and counseling to address obesity and help children maintain a healthy weight.
Women (18-64): Coverage includes cancer screening such as pap smears for those ages 21 to 64, mammograms for those ages 50 to 64, and colonoscopies for those 50 to 64; recommended immunizations such as HPV vaccination for women ages 19 to 26, flu shots for all adults, and meningococcal and pneumococcal vaccinations for high-risk adults; healthy diet counseling and obesity screening; cholesterol and blood pressure screening; screening for sexually-transmitted infections and HIV; depression screening; and tobacco-use counseling. Starting in August 2012, additional preventive services specific to women, such as screening for gestational diabetes and contraception, will be covered by new health plans with no cost sharing.
Men (18-64): Coverage includes recommended immunizations such as flu shots for all adults and meningococcal and pneumococcal vaccinations for high-risk adults; cancer screening including colonoscopy for adults 50 to 64; healthy diet counseling and obesity screening; cholesterol and blood pressure screening; screening for HIV; depression screening; and tobacco-use counseling.
Next up: Major Health Reform Changes Effective in 2011