Congressman Charles B. Rangel joined millions of Americans in celebrating new regulations under the federal Patient's Bill of Rights that go into effect this week, six months after the enactment of the Affordable Care Act.
"I'm proud of President Obama and my Democratic colleagues for paving the road to a healthier and stronger America," said the Congressman, who played an instrumental role in leading the healthcare reform bill out of the Ways and Means Committee. "This is a long-overdue right we've restored for American consumers and patients. For too long, millions of Americans have been at the mercy of their insurance companies as they spiked up rates, denied coverage or dropped patients all together."
Detailed information on the new protective measures taking effect beginning September 23, 2010, can be accessed at http://www.healthcare.gov/index.html.
"These new provisions from the healthcare reform are designed to put you, not the health insurance companies, back in charge of your health care," added the Congressman.
SUMMARY OF THE NEW MEASURES
The following Nine new provisions go into effect on or after Thursday, September 23:
* Health Coverage Cannot Be Arbitrarily Cancelled If You Become Sick
Under the new law, health plans are now prohibited from rescinding coverage except in cases involving fraud or an intentional misrepresentation of facts. Due to pressure from Democrats in Congress and the Obama Administration, insurers agreed to begin implementing this protection early, this spring; so rescissions are now a thing of the past. This protection applies to all health plans.
* Children Cannot Be Denied Coverage Due To A Pre-Existing Condition
The new law prohibits insurance plans both from denying coverage and limiting benefits for children based on a pre-existing condition. This protection applies to all health plans, except "grandfathered" plans in the individual market. These protections will be extended to Americans of all ages starting in 2014.
* Children Up To Age 26 Can Stay On Their Parents' Health Plan
Under the new law, insurance companies are required to allow young people up to their 26th birthday to remain on their parents' insurance plan, at the parent's choice. This provision applies to all health plans. (For employer plans, only those young people not eligible for their own employer coverage receive the benefit, until 2014.)
* Health Plans Cannot Put A Lifetime Limit On Coverage
Millions of Americans who suffer from costly medical conditions are in danger of having their health insurance coverage vanish when the costs of their treatment hit lifetime limits. These limits can cause the loss of coverage at the very moment when patients need it most. Over 100 million Americans have coverage that imposes such lifetime limits. The new law prohibits the use of lifetime limits in all health plans.
* Health Plan's Annual Limits Are Phased Out Over Three Years
The new law phases out the use of annual limits over the next three years. For plan years beginning on September 23, 2010, the minimum level for the annual limit will be set at $750,000. This minimum is raised to $1.25 million in a year and $2 million in two years. In 2014, all annual limits are prohibited. The protection applies to all plans, except "grandfathered" plans in the individual market.
* Patients Have The Right To Key Preventive Services Without Deductible Or Co-Payments
Under the new law, insurance companies must cover recommended preventive services, including mammograms, colonoscopies, immunizations, and pre-natal and new baby care, without charging deductibles, co-payments or co-insurance.
* You Have The Right To Both An Internal And External Appeal
The new law provides the right to an impartial "internal appeal" -- if the health plan doesn't cover a treatment your doctor recommends, or it refuses to pay the bill for the trip to the emergency room. Also, insurance companies will be prohibited from denying coverage for needed care without a chance to appeal to an independent third party.
* You Have The Right To Choose Your Own Doctor
The new law: a) guarantees you get to choose your primary care doctor; b) allows you to choose a pediatrician as your child's primary care doctor; and c) gives women the right to see an OB-GYN without having to obtain a referral first.
* You Have The Right To Access To Out-Of-Network Emergency Room Care At In-Network Cost-Sharing Rates
The new law makes emergency services more accessible to consumers. Health plans will not be able to charge higher cost-sharing for emergency services that are obtained out of a plan's network.