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New Health Reforms Take Effect

By Karen Pallarito
HealthDay Reporter

THURSDAY, Sept. 23 (HealthDay News) -- Thursday marks the six-month anniversary of enactment of the sweeping U.S. health reform legislation, and the day that a number of key provisions of the law begin to take effect.

President Barack Obama signed the Patient Protection and Affordable Care Act on March 23. The law will expand health insurance access to 94 percent of non-elderly Americans by 2019 and, in the interim, provides Americans with many new rights and protections.

"We're seeing the delivery of some of the first promises of reform and there's a lot more to come," said Karen Davenport, director of health policy at the Washington, D.C.-based Center for American Progress.

Here are some of the new reforms set to take effect Thursday. For health plans that operate on a calendar year, many of these provisions will be rolled out on Jan. 1, 2011:

  • Health plans may no longer deny coverage to children based on pre-existing health conditions.
  • Health plans that offer dependent coverage must allow children to stay on a parent's family policy until age 26.
  • New health plans must offer preventive services such as mammograms and colon cancer screenings without charging a deductible, co-payment or coinsurance. (This provision does not apply to existing plans that are "grandfathered," and health plans may require consumer cost-sharing for preventive services received out-of-network.)
  • Health plans that are not grandfathered must provide direct access to a gynecologist without requiring a referral from another doctor.
  • Insurers may no longer place lifetime dollar limits on essential benefits.

Eliminating lifetime caps should provide significant relief for people who are seriously ill or traumatically injured or whose newborn children run up substantial medical bills because of care they receive in a hospital's neonatal intensive care unit.

"We have insurance because we're trying to have financial protection against exactly those kinds of problems," Davenport said. "It's something that all of us hope we never even have to think about, but having it there is going to be really valuable to the people who are in that really horrible situation."

Kirsten Sloan, vice president of the National Partnership for Women and Families, said, "The most important thing about today is that a number of very important insurance reforms go into effect, which makes it easier for women and families to find and maintain or keep insurance."

But many people aren't happy with the new law, and health reform remains a politically charged issue, and one that is likely to have a ripple effect in the November elections.

Seeking to muster public support for the reform package, President Barack Obama on Wednesday talked up the new law at a backyard gathering in Falls Church, Va.

Highlighting the new provisions, Obama said, "All of this is going to lower premiums. It's going to make health care more affordable. It's going to give you more security," the Atlanta Journal-Constitution reported.

But the House of Representatives' Republican Conference released Thursday a pledge to voters outlining key priorities, including "a plan to repeal and replace the government takeover of health care."

The House Republicans' agenda "will focus on getting this economy moving again, getting spending under control, and, yes, it includes rolling back both the failed economic policies and broadly rejected government takeover of health care enacted last March," Rep. Mike Pence of Indiana, who chairs the House Republican Conference, said Thursday on the CBS Early Show.

Consumers remain roughly divided over the law.

The Henry J. Kaiser Family Foundation's most recent monthly health reform tracking poll found 49 percent in favor of the law and 40 percent opposed, foundation President and Chief Executive Drew Altman noted in a column Thursday in the Washington Post.

More information

The federal government has more details of the health reform package.

SOURCES: Karen Davenport, director, health policy, Center for American Progress, Washington, D.C.; Kirsten Sloan, vice president, National Partnership for Women and Families, Washington, D.C.;; House Republican Conference pledge, (; Atlanta Journal-Constitution; CBS News; Washington Post

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