New Health Care Benefits to Start Thursday, Still Embroiled in Political Debate

Sept. 22, 2010— -- Denise Mackey has spent 14 years worrying about whether her son will continue to get treatment for hemophilia, a disease he has struggled with since he was born.

Mackey's son, Sean, hit her health insurance's lifetime cap several times and the family had to turn to state Medicaid.

But with the new benefits that go into effect, starting Thursday, Mackey says she will no longer have to worry about her son's treatment and medicine.

"It definitely is a big weight off our chest," she said, adding that she will no longer have to keep thinking "about chronic illness, worry about where you get your medicine and worrying you can't get it."

Insurance plans renewing on or after Sept. 23 will be required to eliminate lifetime limits on insurance coverage, offer coverage for children with pre-existing condition, remove lifetime caps on coverage, provide free preventive care and allow young adults up to the age of 26 to remain on their parents' health plans, among other changes.

The benefits are expected to affect millions of Americans like Mackey. The Obama administration has ramped up efforts to tout the new law. Today, President Obama held a "backyard event" in Virginia at the home of a person who is benefiting from the Affordable Care Act.

But six months after the landmark bill was signed into law, people are still largely unclear about what the changes mean for them as health care remains embroiled in a heated political debate. More than half of all Americans believe the changes will raise taxes for most people this year, according to an Associated Press poll released Tuesday. About a quarter of respondents thought that the law would set up panels of bureaucrats who would make decisions about people's health, according to the AP.

Overall support for the health care law also remains low, although it goes up when people are asked about specific provisions, demonstrating the confusion among consumers.

A CBS/New York Times poll released last week found that 49 percent disapproved of the health care law, compared to 37 percent who approved. However, less than half of those polled, 40 percent, supported repealing the law, and the number decreased even more when the question of each provision, such as the pre-existing condition, was posed.

Officials insist that as more consumer protection provisions are rolled out, that support will automatically increase.

"People will come to understand the many benefits that are associated with it," said Steve Larson, director of oversight at Health and Human Services. "People have been flooded with misinformation and distortion about what the law does. We are going to continue to do what we can to communicate what the law is all about."

But voices opposing the health care law and new mandates are also growing louder. Opponents are funneling millions of dollars targeting lawmakers who voted for the health care law, and Republicans insist they will continue to fight to repeal the health care law.

"The health care system needs reform, but not the types of changes enacted under the new health care law," said Michael A. Needham, chief executive of Heritage Action for America, who heads grassroots efforts to push for repeal. "This highly unpopular law would assert federal control over health care benefits and financing, erect a complex one-size-fits-all health system and centralize America's health care decisions in Washington."

Health Care Debate Rages on as New Benefits Are Set to Kick In

Crossroads GPS, a conservative non-profit group backed by former President George W. Bush's senior adviser Karl Rove, spent roughly $4 million on ad buys targeting members of Congress who voted for the health care bill. The ads call on Americans to reject "Obamacare," and is one of many targeting the health care law.

Six months after its passage, Democrats and Republicans continue to fight about health care costs. Republicans argue that insurance premiums have risen because of the health care provisions, but administration officials say the new law is being blamed unfairly.

Rate increases have "little to do with passage of the Act and more to do with the marketplace," Health and Human Services Secretary Kathleen Sebelius said in an interview with the National Journal this week.

Family health premiums rose by 3 percent in 2010, and workers on average are paying 14 percent more this year for coverage, according to a Kaiser Family Foundation report released in early September. Many employers are also raising the annual deductibles workers must pay, according to the report.

Sebelius said she expects premium rates to rise by 1 percent to 2 percent, although a recent Wall Street Journal story said carriers have asked for premium increases of between 1 percent and 9 percent to pay for extra benefits required under the law.

While insurance companies have blamed the premium hikes on rising medical costs and inflation, they also hold the new health care law responsible.

"The new benefit mandates are only one of the factors contributing to rising insurance premiums," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans. "Medical costs are rising and premiums are going up because prices for services continue to soar and during the weak economy younger and healthier people have dropped their insurance."

Supporters of the bill argue that premium increases are natural in the short term but that once the health care law is fully implemented, it will help decrease the number of uninsured and put downward pressure on premiums.

"We'll be paying a whole lot less for those who are uninsured because there are fewer of them," said Ken Pollack, executive director of Families USA, which supports the health care law. He added that the new requirements on "medical loss ratio" -- how much of a premium dollar actually goes into health services -- will also help keep a cap on premium hikes.

Here is a look at some of the key policies that will go into effect on or after Sept. 23. Consumers should be entitled to these benefits once their plan is renewed, which is Jan. 1 for most Americans.

Extension of coverage for young adults: Under the new law, children under the age of 26 will be able to stay on their parents' insurance plans for all individual and group policies. Some insurance companies have agreed to implement this policy ahead of schedule, but many Americans will not be eligible for this until their insurance plan is up for renewal, which varies by company.

No pre-existing condition for children: Insurance companies will be barred from denying children coverage based on pre-existing conditions.

Prohibition on rescinding coverage: Insurance companies will be prohibited from cancelling coverage except in cases in which the policy holder commits fraud. This provision applies primarily to the individual insurance market.

Focus on preventive services: Insurers will have to provide preventive services such as mammograms and colonoscopies without cost sharing or charging co-pays.

No lifetime caps on services: Insurance companies will have to remove lifetime caps on plans for both adults and children.

High risk pools: Programs have already been established in some states to provide temporary insurance to those people who have been denied insurance because of pre-existing conditions for at least six months. The high risk pools and premiums differ from state to state.

Premiums can range anywhere from $140 to $900, HHS said in July, with older people having to pay more. The premiums are linked to individual health insurance costs in each state.