December 29, 2013

Commentary: New day in health care dawns Jan. 1

Millions of Americans, in Maine and nationwide, are learning what a bargain quality health coverage can be under the Affordable Care Act.

By Kathleen Sebelius

As we wish our friends and family a happy, healthy New Year, these words have renewed meaning in 2014.

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Cheryl Leonard, left, helps Amy Goldstein with Affordable Care Act paperwork at the Winslow Public Library in October. Starting Wednesday, insurance companies must provide affordable coverage.

2013 Morning Sentinel File Photo/David Leaming

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Kathleen Sebelius

about the author

Kathleen Sebelius is secretary of the U.S. Department of Health and Human Services.

This Wednesday, Jan. 1, will mark a new day in health care for millions of families and individuals throughout Maine.

Starting Wednesday, it will be against the law for insurance companies to deny you coverage or charge you more because of a pre-existing medical condition like diabetes, high blood pressure or asthma. And they will no longer be able to drop you from coverage just because you get sick or get into an accident.

What’s more, insurance companies will no longer impose an annual cap on your health benefits. They won’t be able to deny you coverage simply because you made a mistake on your paperwork. Most plans must cover preventive services like cholesterol and cancer screenings, at no out-of-pocket cost. And being a woman will no longer be a pre-existing condition.

It’s all thanks to the health care law: the Affordable Care Act.

If you do not have health insurance through your job, you have an opportunity to obtain quality, affordable coverage through HealthCare.gov. In fact, you may even qualify for financial assistance to help lower the cost of your premiums.

The Health Insurance Marketplace has brought choice and competition to Maine that were previously unavailable: In the Portland area, you can choose from 17 qualified health plans.

As millions of Americans learn about their new options, they’re finding just how affordable health coverage can be under the new law. A family of four in Portland earning $50,000 per year can obtain affordable coverage for as little as $103 per month (with premium tax credits).

Nationwide, six in 10 uninsured Americans can obtain coverage for as little as $100 a month or less.

And make no mistake: The plans offered on the marketplace are actual, honest-to-goodness health insurance. By law, they must cover a set of essential benefits, including visits with doctors, prescription medications, hospital stays, ambulatory care, maternity and newborn care and preventive services.

You still have three more months to enroll in affordable coverage – the deadline is March 31.

If you want your health insurance to begin Feb. 1, you’ll need to sign up by Jan. 15.

You can enroll online at HealthCare.gov, by phone at (800) 318-2596/TTY (855) 889-4325, on paper or directly through an insurer, agent or broker. You can also find in-person assistance in your own community at LocalHelp.HealthCare.gov.

This is a milestone for the many families who have waited too long for affordable health insurance because of a broken system that was stacked against them. Before today, Americans could be dropped from coverage when they got sick, or locked out of the system if they had a health condition, or priced out in the first place because of their health status. Now, not only are there new rights and benefits, but we are also seeing the slowest health care price inflation in 50 years.

Whenever I travel, I meet folks who tell me how long they’ve been waiting for the opportunity to obtain affordable coverage. Some have even been waiting their entire lives.

I keep thinking about Diane, whom I met recently in Michigan. In the past, Diane’s pre-existing medical condition had made finding quality, affordable health insurance nearly impossible.

After being uninsured for more than six years, Diane recently enrolled in coverage using HealthCare.gov. Now Diane no longer needs to worry about treating her condition – or going bankrupt because of an unexpected illness or injury.

For Diane and for millions of Americans like her, Jan. 1 will be a new day in health care because of the Affordable Care Act. And we continue to work together toward the goal of making affordable coverage accessible to every American who wants it.

— Special to the Telegram

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