Ken Plum: Affordable Care Act

Another phase of the Affordable Care Act (ACA) became effective this week. Although controversial among some politicians who refer to the Act as “Obamacare,” it is proving extremely beneficial for those who have had limited or no access to health care. As the benefits of the program become more obvious, these same politicians may regret associating the President’s name with a program that is on its way to making huge improvements in health care for Americans.

Even at such an early stage, the benefits of the new health care law are already becoming apparent. Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition. Young adults under 26 can be eligible to be covered under their parents’ health plan. Insurers can no longer cancel insurance coverage just because you made an honest mistake. You have the right to an appeal if a claim you made was denied. Lifetime limits are banned for all new insurance plans, and your premium dollars must be spent on health care and not administrative costs. Preventive health services will be covered in most instances.

Despite the advantages of the new health plan and its expanded coverage of Virginians, the Governor and the Republicans in the General Assembly have been dragging their feet in implementing the law. In an uncharacteristic move, the Governor chose to let the federal government run the health insurance exchanges in Virginia. The State Corporation Commission will perform some plan management functions. For individuals buying their own insurance, the exchange will provide comparable data on more than 30 different insurance plans from which individuals and families can make an informed decision. Already the exchanges are producing rates that are lower than insurance rates in the past.

The expansion of Medicaid to cover many more of the working poor who are currently not insured has been held up in Virginia for study and reforms. The commission studying the expansion is scheduled to report in December. It would be a terrible mistake for Virginia to not take back the federal dollars it pays to insure its very own citizens who need it most.

The ACA will bring incredibly important changes to health care in this country, but it is a complex law. To better understand it in more detail than I can provide here, I suggest that you visit the official U.S. Government site, healthcare.gov. The Virginia Health Care Foundation has important information on its site along with links to other sources; go towww.vhcf.org/data/health-reform/. The Kaiser Family Foundation has easy-to-understand charts on the Affordable Care Act at  http://kff.org/aca-consumer-resources/. The Commonwealth Institute for Fiscal Analysis (www.thecommonwealthinstitute.org) has a number of studies on health care reform in Virginia.

It is time for Virginia’s political leaders to embrace the reform or get out of the way so that its citizens can enjoy its benefits.