M.J. Ellington: Defund and we lose
by M.J. Ellington
Special to The Star
Sep 19, 2013 | 2435 views |  0 comments | 30 30 recommendations | email to a friend | print
Signup for the Health Insurance Marketplace in Alabama is only days away, and once again opponents of the Affordable Care Act vow to overturn the law designed to make quality health coverage available to all Americans.

But even the most outspoken opponents might think twice about demanding that Congress kill the program if they knew what Alabamians just like them stood to lose if it went away. Here are some ways the ACA is helping those of us who already have coverage.

Your child can stay on your family health insurance plan until age 26. The Affordable Care Act put this provision into effect in 2010, enabling young adults to stay on their parents’ plan until their 26th birthday. In the past, families wanting to keep young adults insured with quality coverage often paid hundreds of extra dollars per month for expensive COBRA coverage.

Preventive care checkups and immunizations are free on most health plans. Already, women know there is no charge for the mammograms they used to pay extra for. Preventive tests, including cholesterol and blood pressure screenings and immunizations that used to cost extra are free on most plans. Only plans that have had no significant changes in benefits or cost since March 23, 2010 (the day the ACA passed), are exempt from this requirement.

There are no more pre-existing condition exclusions for children. Before ACA, an insurance company could turn down health claims and refuse to insure even a newborn with serious health problems. The decision often resulted in thousands of dollars in unbudgeted expenses for worried new parents and made it difficult to acquire coverage long into the future. The ACA did away with pre-existing condition exclusions for children in 2010.

Starting Jan. 1, pre-existing condition exclusions will end for adults as well.

Your insurer must spend at least 80 percent of what you pay in premiums on your health care. Before the ACA, there was no such requirement. Small businesses and individual policyholders most frequently covered by such plans often faced high out-of-pocket costs in addition to expensive premiums.

Now, insurers that do not comply with minimum coverage requirements must rebate excess premium charges to customers each year.

The Medicare doughnut hole for prescription drug coverage is shrinking and will be gone by 2020. Some of the sickest senior citizens and disabled people with Medicare Part D drug plans often had thousands of dollars in extra drug expenses they had to pay because of a coverage gap called the donut hole. The gap will disappear in 2020 under the ACA.

These protections will extend to thousands of uninsured Alabamians when the Alabama Health Insurance Marketplace opens for early enrollment on Oct. 1. At the online Marketplace, individuals and small businesses with 25 or fewer employees can compare qualified health plans offered in Alabama, sign up for coverage that begins Jan. 1 and see if they qualify for tax credits that make premiums affordable.

Learn more about Alabama’s Marketplace at www.HealthCare.gov or call the toll-free consumer help line any time at (800) 318-2596 or TTY (855) 889-4325. The more Alabamians know about their new health benefits, the harder it will be to take those benefits away.

M.J. Ellington is a health policy analyst with Arise Citizens’ Policy Project.
Comments must be made through Facebook
No personal attacks
No name-calling
No offensive language
Comments must stay on topic
No infringement of copyrighted material


Friends to Follow



Most Recommended

M.J. Ellington: Defund and we lose by M.J. Ellington
Special to The Star

Today's Events

event calendar

post a new event

Sunday, April 20, 2014

Marketplace