6 Real-Life Scenarios Changed by the Health Care Bill

After a year of back and forth on health care reform, few people have a clear idea of what the mammoth bill President Obama will sign will actually mean for them.

While the majority of people with employer-sponsored health insurance will have to wait and see whether the bill will help or cost them money, change may be coming to millions of Americans sooner.

VIDEO: Rx Drug Coverage: Closing the Donut Hole
Closing the Prescription Drug 'Doughnut Hole'

Below are six types of individuals -- from the poor, to the sick and the young -- who are likely to see their health insurance options change.

Those Who Fall Into the Medicare 'Doughnut Hole'

For 73-year-old Pat Englehardt, being in the "doughnut hole" meant that every year she paid $4,000 to $5,000 for the medications she needs.

"I cannot go visit my children as often as I would like," Englehardt told "Good Morning America" today. "If the plane is too expensive, I don't make the trip."

VIDEO: Protesters and politicians sound off on health care reform bill.
48 Hours of High Drama on Health Care

The doughnut hole refers to an absence of Medicare drug coverage after a patient has spent a certain amount -- in Englehardt's case, $2,830. Like millions of other older Americans, once she exceeded this amount she had to pay full cost for her drugs. Coverage kicks in again when patients reach a predetermined level of spending, but not before they have spent thousands of dollars out of pocket.

Englehardt's struggle with her drug costs reached a breaking point when the cost of her blood thinner medication jumped from $204 to $1,480, and her cholesterol medication went from $16 to $224.

"It's expensive," John Rother, executive vice president for policy and strategy at AARP told "Good Morning America." "Many stop taking their medications as a result."

Now that there is a new law, those like Englehardt will get a $250 rebate this year. Beginning in January 2011, they'll get a 50 percent discount on all of the drugs for which they used to pay full price. Had similar provisions been in place this year, Englehardt would have saved $1,500.

"This is very important both for the pocketbook of seniors because the drugs are expensive and getting more expensive every year," Rother said.

Englehardt, for one, is already looking forward to her savings next year.

"I may get to California with these new provisions to visit one of my children," she said.

The Millennials: Calling Young Adults Under Age 26

Adults younger than 26 -- sometimes called Gen Y or "Millennials" -- will have a new option for insurance.

Under the legislation, unmarried young adults younger than 26 who don't have health insurance have a right to remain on their parent's health insurance family plan. Current law varies by state on age limits, with some states extending parent insurance through the college years and other states allowing health insurance plans to drop young adults much sooner.

"The biggest block of the uninsured are the young adults who have grown out of their parents' insurance," said Thomas Oliver, professor of population health sciences at the University of Wisconsin School of Medicine and Public Health, in Madison.

"In a lot of states, when you hit age 18, boom you're gone," he said.

Oliver said many young adults in that age group either have jobs without benefits, or are taking unpaid internships to start a career or simply do not make enough working jobs to buy their own health insurance.

Page
  • 1
  • |
  • 2
  • |
  • 3
  • |
  • 4
Join the Discussion
You are using an outdated version of Internet Explorer. Please click here to upgrade your browser in order to comment.
blog comments powered by Disqus
 
You Might Also Like...