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Nearly all states have taken action on Affordable Care Act's Patients' Bill of Rights

March 22, 2012, New York, NYAs the second anniversary of the Affordable Care Act approaches, a new Commonwealth Fund report finds that 49 states and the District of Columbia have already taken action supporting the law's implementation, such as passing legislation, issuing regulations or other guidance, or actively reviewing insurer filings. Early insurance market reforms in the law include new rules for insurers such as bans on lifetime limits on benefits and dependent coverage for young adults up to age 26.

The report, Implementing the Affordable Care Act: State Action on Early Market Reforms, by Katie Keith, Kevin W. Lucia, and Sabrina Corlette of the Georgetown University Health Policy Institute's Center on Health Insurance Reforms, is the first to assess state action on 10 early reforms, including those known collectively as the Patients' Bill of Rights, that went into effect in September 2010. The researchers found that between January 1, 2010, and January 1, 2012, 23 states and the District of Columbia had taken new legislative or regulatory action on at least one of these reforms, and an additional 26 states had taken other action to promote compliance with the reforms, such as issuing bulletins to insurers.

The reforms in the study include:

  • expanding dependent coverage for young adults up to age 26,
  • prohibiting lifetime limits on health benefits,
  • phasing out annual dollar limits on health benefits,
  • prohibiting preexisting condition exclusions for children under age 19,
  • prohibiting rescissions (cancelling insurance, except in cases of fraud or intentional misrepresentation),
  • covering preventive services without cost-sharing,
  • expanding coverage of emergency services,
  • allowing choice of primary care provider,
  • allowing choice of pediatrician, and
  • allowing access to obstetricians and gynecologists without a referral.

"In just a year and a half since these early reforms

Contact: Mary Mahon
Commonwealth Fund

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