Thursday, September 23, 2010


Lesley Lopez

Press Secretary

UPDATE: ‘Patient’s Bill of Rights’ to Begin Today

Washington- Today, Congressman Henry Cuellar announced that several important consumer protection features of health reform are set to go into effect today, September 23rd, six months after Affordable Care Act was signed into law. Better known as the Patient’s Bill of Rights, these provisions seek to end insurance company abuses.

“Starting today, key patient rights and protections begin to take effect. This new “Patient’s Bill of Rights” is designed to put you and your doctor – not the health insurance companies -- back in charge of your health care.

Up until now, insurance companies have often left patients without coverage when they needed it most -- causing them to put off needed care, thereby compromising their health and driving up the cost of care when they got it.

As a father, one of the major issues for me was denying children coverage for pre-existing conditions, like asthma. If your child is ill, please know that these reforms will ensure your child can get the help he or she needs.

Here is what the Patient’s Bill of Rights will mean for you:

THEN: Insurance companies were able to retroactively cancel your policy when you became sick, if you or your employer had made an unintentional mistake on your paperwork.

NOW: The new law prohibits insurance plans from rescinding your coverage when you get sick, except in cases of fraud or an intentional misrepresentation of facts. (Applies to all insurance plans.)

THEN: Every year, thousands of families have been denied insurance for their children just because they were born with a health condition or they have become sick.

NOW: The new law prohibits insurance plans both from denying coverage and limiting benefits for children based on a pre-existing condition. (Applies to all employer plans and new individual plans.)

THEN: Over 100 million Americans have been enrolled in insurance plans that impose lifetime limits on coverage – meaning when a catastrophic illness strikes, they were in danger of bankruptcy when their health costs exceed the limit.

NOW: The new law outlaws lifetime limits; no longer will a family go broke or lose their home just because a loved one has an accident or becomes ill. (Applies to all insurance plans.)

THEN: Even more aggressive than lifetime limits are annual dollar limits on what an insurance company will pay for health care. The insurance plans of millions of Americans have had such annual limits.

NOW: The new law phases out the use of annual limits; ensuring that the coverage of hundreds of thousands of Americans will no longer be cut off right when they need it most. (Applies to all employer plans and new individual plans.)

THEN: Most insurance companies did not allow parents to keep their young adult children on their plan, as the children worked to launch their careers.

NOW: The new law requires insurance plans that offer family coverage to allow young people up to their 26th birthday to remain on their parents’ insurance plan, at the parent’s choice. (Applies to young people who do not have access to their own employer-sponsored coverage.)

THEN: Insurance companies didn’t always make it easy to see the doctor you choose.

NOW: Patients are guaranteed their choice of primary care doctor within their plan’s network of doctors, including OB-GYNs and pediatricians without a referral. (Applies to new plans.)

THEN: Each year, thousands of Americans have gotten hit with exorbitant charges from their insurance company when they got sick or injured when they were away from home and used an out-of-network emergency room.

NOW: Under the new law, insurance plans will not be able to charge higher cost-sharing for emergency services that are obtained out of a plan’s network. (Applies to new plans.)

THEN: Millions of Americans did not have the right under their insurance plan to have an “external appeal” of insurance company decisions.

NOW: The new law prohibits insurance companies from denying coverage for needed care without a chance to appeal to an independent third party. (Applies to new plans.)

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