Bingaman: Reform Law Expanding Health Care Access and Protecting New Mexicans from Health Insurance Company Abuses

Press Release

Six months after a new health insurance law was enacted, U.S. Senator Jeff Bingaman said it is beginning to take effect in New Mexico and across the country. The law expands access to health services and creates important protections for New Mexico families against some of the worst insurance company abuses.

"Starting September 23, health insurance companies are required to expand health care access and to end many abuses they have employed for years. These unfair practices have left too many New Mexicans without coverage for serious medical conditions or made coverage too expensive for families," said Bingaman, who helped write the Patient Protection and Affordable Care Act. "Combining these new protections with many others that phase-in over the next few years, this law will greatly benefit New Mexicans."

For example, beginning tomorrow -- six months to the day after President Obama signed the Patient Protection and Affordable Care Act into law -- new health insurance policies being sold must allow young adults up to age 26 to be covered by their parents' policies, unless they are offered coverage at work. In New Mexico, this provision could ensure that up to 13,000 young adults will be able to stay on their parents' coverage.

A description of how New Mexicans will benefit now from the new law can be found here. Other benefits starting as of September 23 include:

Ban on Discriminating Against Children with Pre-Existing Conditions: Before the new health insurance reform law, tens of the thousands of families had been denied insurance each year for their children because of an illness or condition. Starting September 23rd, plans cannot discriminate against kids with pre-existing conditions. In 2014, no one seeking coverage can be discriminated against because of a preexisting condition.

Ban on Insurance Companies Dropping Coverage: Before the new law, insurance companies could cancel your coverage when you got sick and needed it most because of a simple mistake on your application. Starting tomorrow, insurance companies are banned from cutting off coverage due to an unintentional mistake on your application.

Ban on Insurance Companies Limiting Coverage: Before reform, cancer patients and individuals suffering from other serious and chronic diseases were often forced to limit or go without treatment because of an insurer's lifetime limit on their coverage. Starting tomorrow, insurance companies can no longer put a lifetime limit on the amount of coverage they provide, so families can live with the security of knowing that their coverage will be there when they need it most. Up to 20,400 people who typically hit their lifetime limits on the dollar amount that can be spent on coverage, along with the nearly 102 million enrollees who have policies with lifetime limits, will no longer have to worry about hitting their benefits caps. The use of annual dollar limits will be restricted, and in 2014 will be banned completely. By 2013, up to 3,500 people will gain coverage as a result of the ban on annual limits that insurers impose on nearly 18 million people today.

Ban on Insurance Companies Limiting Choice of Doctors: Before reform, insurance companies could decide which doctor you could go to. Starting tomorrow, if you purchase or join a new plan you have the right to choose your own doctor in your insurer network. Up to 88 million people will benefit from the provision that protects primary care provider choice by 2013.

Ban on Insurance Companies Restricting Emergency Room Care: Before reform, insurance companies could limit which emergency room you could go to or charge you more if you went out of network. Starting tomorrow, if you purchase or join a new plan, those plans are banned from charging more for emergency services obtained out of network. Up to 88 million people will benefit from this provision.

Guarantee You a Right to Appeal: Before reform, when insurers denied you coverage or restricted your treatment, you were left with few options to appeal. Starting September 23rd, if you purchase or join a new policy, you will be guaranteed the right to appeal insurance company decisions to an independent third party. Up to 88 million people will benefit from the new appeals process provisions by 2013.

Covering Preventive Care With No Cost: Starting September 23rd, if you join or purchase a new plan, you will receive recommended preventive care with no out-of-pocket cost. Services like mammograms, colonoscopies, immunizations, pre-natal and new baby care will be covered and insurance companies will be prohibited from charging deductibles, co-payments or co-insurance. Up to 88 million people will have access to preventive care with no out of pocket costs.

Source