KVH Statement on 2nd Anniversary of Coverage Provisions of ACA

For Immediate Release | September 24, 2012

Contact: Jodi Mitchell, 502-882-0584 | KVHexec@kyvoicesforhealth.org

As the debate over the Affordable Care Act (ACA) rages on, there are some portions of the law that undoubtedly bring additional benefits to Americans, particularly those of us here in Kentucky. 

On September 23, 2010, several important provisions were established to help keep Americans covered while diminishing the inherent insurer upper hand that had plagued the insurance system for so long. These new provisions were a step in the right direction for reforming insurance practices that often left people without coverage. 

The provisions added two years ago, stated that insurers can no longer deny people coverage because of pre-existing conditions, nor can they drop coverage because a policyholder gets sick. Likewise, insurers are no longer allowed to impose lifetime dollar limits on coverage of essential benefits or bill policyholders into bankruptcy because of these lifetime limits. 

The provisions also helped to close the Medicare Prescription Drug Part D “doughnut hole” or gap that had left so many seniors without a way to pay for expensive prescription medications. In 2012, nearly 70,000 Kentucky seniors who fell into this gap received a $250 rebate to help cover costs. Additionally, in the first five months of 2012 almost 16,000 Kentuckians on Medicare were given a 50 percent discount on band-name prescription medications. 

These provisions also opened coverage up to additional sectors of the population, closing the gap between those who are and are not covered. For instance, the provisions allow for dependents under the age of 26 to be covered under their parents’ insurance, making it possible for post-college graduates who can’t get benefits through their employer to have coverage. As of 2011, 3.1 million young people who did not have coverage before were now covered under this provision and an estimated 48,000 young adults in Kentucky are now eligible for coverage under their parent’s policy. 

Additionally, insurance companies must now provide free preventative care and medical screenings, like cancer or diabetes screenings, to policyholders without charging co-pays. This includes a free wellness visit with their doctor once a year. This new policy will go along way in preventing illnesses as well as helping to catch illnesses early, saving insurers and policyholders’ money in the long run while also saving lives. 

Perhaps one of the most important provisions secured two years ago is the adoption of new methods of guaranteeing value to consumers while promoting information sharing to policyholders. Insurers must now adhere to a strict 80/20 rule meaning that 80 percent of every premium dollar must be spent on providing health care or quality improvements and only 20% can be used to pay for administrative costs, overhead, marketing services or executive salaries. Insurance companies have already worked to meet this ratio by distributing rebate checks to consumers. Nearly 250,000 Kentuckians with private insurance coverage have already received rebates averaging out to $114 per family. 

Unfortunately, our country has a long history of letting insurers deny or drop coverage to policyholders at times when they need coverage the most. For too long we have had a culture where people have no information about their own health care, where it is common for families to go bankrupt trying to pay for health care, and treatments to help prevent expensive and life-threatening illnesses get put on the backburner by insurers. 

With the implementation of the Affordable Care Act and with the anniversary of the additional provisions added on September 23, 2010, it is now possible for more people to enjoy the benefits of affordable health coverage with the guarantee that consumers will get good value for their premium dollars. These provisions force insurance companies to finally play by the rules and more importantly, help more Americans receive the health coverage that they need. 

Kentucky Voices for Health is committed to educating Kentuckians about those measures that stand to positively impact the health care landscape in Kentucky. Among our top priorities is improving access to affordable care.   This provision will also improve efficiency and effectiveness in the system by making the spending habits of insurers more transparent. 

Kentucky Voices for Health is a broad coalition of nearly 250 organizations and individuals working to improve Kentuckians’ health and health care coverage. Kentucky Voices for Health has been supported by the Public Welfare Foundation and in part by the Foundation for a Healthy Kentucky.  

###

• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
•