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Health Reform’s Gifts For Mom: Celebrating Mother’s Day With Healthier Mothers, Mothers-To-Be, And Grandmothers

Mothers care for their children, spouses, and aging parents around the clock. Many moms work full-time jobs on top of caregiving. But who cares for Mom?

This Mother’s Day, moms can celebrate health care reform’s new provisions that help moms, moms-to-be, grandmothers, and their families to get healthy and stay healthy. Here are some of health care reform’s “gifts” that moms can already enjoy, as well as a sneak peek of gifts to come.

Moms

One of the biggest worries for moms is their kids. Kids get sick, get hurt, and were denied health insurance prior to health care reform. But thanks to reform, moms have support whether they have a young child with a preexisting condition or a college graduate whose employer doesn’t cover them. Insurance companies can no longer deny insurance to children with preexisting conditions, and children up to age 26 can stay on their parent’s plan if their employer doesn’t offer coverage.

But reform looks out for Mom, too. The Affordable Care Act provides free screenings of many of women’s biggest health concerns: breast cancer, cervical cancer, blood pressure, cholesterol, and obesity.

Paired with improvements in primary care, we know this preventive approach will drastically improve the health of moms and their families. We know, for instance, that regular pap smears increase the likelihood of detecting cervical cancer early and subsequently increasing survival rates.

The bottom line? Free screenings allow doctors and their patients to address health problems earlier and help prevent Mom from getting sick.

And if Mom still gets sick, health care reform provides support there, too. Provisions now prohibit annual and lifetime caps, meaning that a person who is severely or continually ill will not “run out” of insurance.

Moms-to-be

Moms-to-be can look forward to the guarantee that all health plans will cover maternity care for the first time. This is especially exciting since prior to health care reform, 22 states offered no coverage of pregnancy-related costs under any health care. Further, in a study conducted by the National Women’s Law Center, only 13 percent of studied health plans in the individual market provided maternity care.

Maternity coverage will also include preventive and prenatal services. For instance, women considering pregnancy can receive free folic acid supplements while pregnant women can receive free, routine screening for anemia. Taking folic acid previous to getting pregnant and during the first trimester of pregnancy helps prevent birth defects and is essential to the development of the fetal nervous system. Further, pregnant women with iron-deficient anemia are at increased risk of preterm deliveries, delivering babies with a low birth weight, and even fetal death.

Finally, new moms will see additional postnatal benefits. Mothers will receive breastfeeding support such as prenatal and postnatal breastfeeding education and evaluation from trained caregivers. This has proven health benefits for both mothers and their children. Additionally, moms who go back to work will benefit from a private space to breastfeed because employers are now required to provide one.

Grandmothers

Grandmothers can stay stronger for longer with free annual checkups covered by Medicare. The physicals are available to every Medicare beneficiary and they don’t cost a thing.

In addition, other health plans will allow grandmothers to receive preventive care without copays or deductibles. All new plans must include free osteoporosis screeninga disease affecting mainly older women that causes the bones to weaken and severely increases the likelihood of fractures and breaks—for women over 65 and for women at higher risk over age 60.

Finally, provisions in health care reform are working to close the “doughnut hole” in which people enrolled in Medicare’s prescription drug program, often women, are forced to pay a greater share out of pocket for prescription drugs due to a gap in coverage. In the last year Medicare beneficiaries received a $250 rebate. In coming years there will be discounts on brand-name and generic prescription drugs, and provisions will work to make it so by 2020 the doughnut hole will be closed.

Future gifts

While many of these “gifts” to mothers are already in place, more gifts will arrive in the next two-and-a-half years.

For starters, because of new and expanded programs, more moms will have health insurance. These new programs will make it so insurance plans include even more mom and family-friendly services that build on the aforementioned maternity, preventive, and Medicare benefits.

Finally, for the first time, women—mothers included—will pay the same rate for health insurance as men. Forty-two states currently allow gender rating (charging women more than men for the same health plan), with some charging up to 84 percent more. This is a huge, long-awaited gift to women and moms everywhere.

Health care reform acknowledges moms’ 24/7 care. That’s why the law works to serve moms every day and not just Mother’s Day.

By: Sandra Bogar, Center for American Progress, May 5, 2011

May 5, 2011 Posted by | Affordable Care Act, Health Care, Health Reform, Insurance Companies, Medicare, Uninsured, Women, Women's Health, Womens Rights | , , , , , , , , , , , , , | Leave a comment

Health Reform at Work Today and Tomorrow: Improvements That Began Last Year Will Continue

President Barack Obama is applauded as he signs the health care reform bill, on March 23, 2010, in the East Room of the White House in Washington. The bill includes many benefits for Americans who have health insurance today and those who have struggled to find and maintain health coverage.

2010 was a momentous year for the American health care system. In March, Congress passed—and President Barack Obama signed—landmark legislation that reforms the health insurance market, provides all Americans with affordable access to health coverage, and reduces the growth of health care costs.

The Department of Health and Human Services and other parts of the executive branch have begun to implement the new law in the subsequent 10 months. The Affordable Care Act, or ACA, includes many benefits for Americans who have health insurance today and those who have struggled to find and maintain health coverage. Many of these benefits came on-line in 2010.

Signature achievements include:

  • Establishing pre-existing condition insurance plans in every state so that individuals with health problems who cannot find coverage in the regular market have a reliable source of coverage
  • Requiring employer-sponsored health plans to offer coverage to the young-adult children of policyholders
  • Helping employers with unpredictable health care spending for retired workers
  • Providing more than 1 million rebate checks to Medicare enrollees who incurred high out-of-pocket prescription drug spending in 2010
  • Prohibiting health insurance plans from denying coverage to children with pre-existing conditions
  • Protecting individuals with high health care costs from the financial risk of absurdly low annual and lifetime limits on their benefits
  • Prohibiting health insurance plans from rescinding coverage when a policyholder gets sick

These changes bring a new degree of stability and security to millions of Americans’ health coverage. And even more improvements are around the corner. Beginning this month, seniors will enjoy meaningful new benefits and significant improvements in their prescription drug coverage, while individuals and businesses will receive premium rebates from their insurance company when the insurers incur excessive administrative costs.

Specific improvements in 2011 include:

  • Closing the Medicare prescription drug coverage gap. Seniors and people with disabilities who obtain prescription drug coverage through Medicare Part D will enjoy a new discount on brand-name and generic prescription drugs when they hit the so-called “doughnut hole” in their Part D benefits. Since the beginning of the program, enrollees have hit a gap in coverage when their total drug spending—including out-of-pocket costs and expenses covered by their Medicare Part D plan—exceeds a preset limit (currently $2,830). Patients then pay the total cost of their prescription drugs, without help from their drug plan, until their total drug expenses hit an upper limit and coverage kicks in again. With the new discount, people with drug spending high enough to hit the coverage gap will save almost $500 on average this year, while people with very high drug costs will save more than $1,500.
  • Launching new prevention benefits for Medicare enrollees. Good coverage of preventive services helps seniors and other Medicare enrollees better manage their health. New benefits include coverage without cost-sharing for recommended preventive services (those that receive an “A” or “B” rating from the U.S. Preventive Services Task Force) and new coverage for a personal prevention plan.
  • Increasing access to primary care. Medicare will pay primary care providers a 10 percent bonus payment, which offers a new incentive for physicians, nurses, and others to provide primary care services.
  • Requiring insurers to provide high value for premium dollars. Beginning in 2011, insurers will pay rebates to policyholders—individuals and employers—when plan spending on clinical services falls below 80 percent of premium revenue in the individual and small group market, and 85 percent of premium revenue in the large group market.

Looking ahead, ACA provisions that will touch real people every day will continue coming on-line through 2011. These include providing more consumer information on healthy food choices by requiring chain restaurants and vending machines to provide nutritional data no later than March, and improving long-term care by sending enhanced federal Medicaid payments to support new state investments in community-based long-term care services starting in October. Tangible improvements will continue beyond this year, such as fully closing the coverage gap in Medicare Part D and improving Medicaid coverage for preventive care.

The Affordable Care Act’s most striking impact will come in 2014 when new health insurance exchanges launch, premium subsidies become available, and Medicaid coverage expands to include all low-income individuals regardless of family composition, age, or disability status.

These headline-grabbing changes in our health care system may be a few years down the road. But millions of Americans are already benefiting from the Affordable Care Act—and millions more will receive better care in the near future thanks to the changes in the new law.

By Karen Davenport | January 13, 2011-Center For American Progress. Photo: AP/Charles Dharapak

January 15, 2011 Posted by | Health Reform | , , , , , , , , , , , , , | Leave a comment

   

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