Affordable Care Act at 3: Consumer Protections

By Kathleen Sebelius, Secretary of Health and Human Services
Posted March 18, 2013

In the past, too many parents had to worry about how they would pay the mortgage or the car payment if their sick children were dropped from insurance coverage. Victims of breast cancer worried about what would happen to them or their families if they reached a lifetime limit on coverage and no longer could afford treatment.

These were real concerns for real people. Because of the health care law, however, they can put these worries aside and know they are getting a better value for their premium dollars.

The Affordable Care Act brings an end to some of the worst insurance industry practices that have kept affordable health coverage out of reach for millions of Americans, especially when they needed it most. Under the health care law, consumers can be confident that their insurance will protect them if they get sick and their families won’t be crushed by medical bills.

As we observe the third anniversary of the President signing the health care law, let me tell you what this means in real terms to many American families:

  1. For Alycia Steinberg of Towson, MD, whose 4-year-old Avey has leukemia, the health care law gives her the ability to focus on her daughter’s health without worrying that she might be denied coverage because of her illness.
  2. Tracy Wirtanen-DeBenedet of Appleton, WI, can manage her 10-year-old son’s fight against recurring tumors without worrying about his health insurance being denied or coverage capped at a lifetime dollar limit—the health care law makes lifetime limits illegal.
  3. Judy Lamb of Colorado is being treated for breast cancer that has spread to her bones and liver. These treatments cost hundreds of thousands of dollars a year, but Judy says she is no longer “freaked out” by the possibility that her insurer will cut off her treatment by imposing a lifetime dollar cap on her coverage of essential health benefits. Judy is doing so well now, she’s thinking about going back to work as a nurse.

In addition to helping those with great need, the health care law helps us all stay healthy in the first place.

Consumers now have the right to many vital preventive services at no out-of-pocket cost.

According to a new report, about 71 million Americans in private insurance plans received expanded coverage of preventive services, such as mammograms and other cancer screenings, flu shots, and cholesterol checks, at no additional charge in 2011 and 2012.

In addition, insurance plans are now covering without cost-sharing more prevention-related services for women, such as well-woman visits, breastfeeding support and supplies, and gestational diabetes screening. This will guarantee nearly 47 million women access to these vital services at no charge.

Medicare beneficiaries are also eligible for key preventive services at no out-of-pocket cost. Last year, more than 34 million seniors and people with disabilities on Medicare used at least one free preventive service, such as mammograms and cholesterol screenings.

Even more new protections will apply to most plans beginning in 2014. The new protections will prevent insurers from denying coverage because of a pre-existing condition like asthma or heart disease, or charging more because of a person’s gender or occupation. That means an insurer will no longer be able to charge women more than men for the same coverage or charge firefighters, first responders, and others more just because of their jobs. Being a woman will no longer be a pre-existing condition.

The bottom line is consumer protections and preventive services under the Affordable Care Act are giving millions of Americans more for their health care dollars.

And beginning October 1, 2013, qualified individuals will be able to shop for health insurance based on benefits, quality and price through the Health Insurance Marketplace (otherwise known as an Exchange) in their state. Should you need help sorting through your options, the Marketplace will offer experts and tools free of charge to assist you.

The Affordable Care Act is giving you greater control over the care you need and deserve.

Learn more about the key features of the Affordable Care Act.

Find out about the Health Insurance Marketplace and sign up for email and text updates at https://signup.healthcare.gov.

Follow Secretary Sebelius on Twitter at @Sebelius.