Sen. Carper Highlights Key Health Care Provisions that Benefit Delaware Families

WASHINGTON – Today Sen. Tom Carper (D-Del.) highlighted the implementation of several key provisions of the Affordable Care Act.  These common sense measures will help hold insurance companies accountable to consumers, bring down costs for everyone, and provide Delaware residents with the insurance security and choices they deserve.  


"Families and employers in the First State have already begun to benefit from the historic health reform legislation we passed six months ago, and today marks another important milestone as more reforms become effective," said Sen. Carper.  "To date, Delawareans and all Americans have been able to access a temporary high-risk pool – the Pre-Existing Condition Insurance Plan. Medicare beneficiaries who hit the "donut hole" have begun getting $250 rebate checks as a result of the health reform law.  Today more benefits will come online with the implementation of the new Patient’s Bill of Rights, which will better protect patients from unfair practices by health insurance companies, help ease the burden felt by families and businesses due to rising health care costs, and ensure that patients can choose their own primary care doctors."


Here are just a few examples of the benefits for Delaware residents that go into effect for policy or plan years starting or renewed after September 23, 2010: 


An estimated 510,000 Delaware residents who purchase private insurance will no longer have to worry about lifetime limits being placed on coverage. 


An estimated 2,300 Delaware young adults may be able to stay on their parents’ health insurance plan until their 26th birthday.


In addition to these benefits, the Affordable Care Act makes preventive care more accessible and affordable for all Delawareans by requiring new health insurance plans issued on or after September 23, 2010, to cover recommended preventive services without charging a copayment, coinsurance, or deductible. [, 7/14/10]   Starting in 2011, all 140,000 Medicare enrollees in Delaware will get preventive services, like colorectal cancer screenings, mammograms, and an annual wellness visit without copayments, coinsurance, or deductibles.


Before passage of the Affordable Care Act, insurance companies could retroactively cancel consumers’ health insurance if they became sick, required costly health care services, or made unintentional mistakes on insurance paperwork.  Insurance companies could also set lifetime and annual limits on coverage, leaving thousands of Delaware residents in danger of having their health insurance coverage virtually vanish when the costs of their treatment hit those caps.  With the passage of health care reform, all health insurance plans issued or renewed on or after September 23, 2010, will be prohibited from rescinding coverage except in cases of fraud or intentional misrepresentation and the plans will be prohibited from imposing lifetime limits on coverage. The use of annual limits in all new plans and existing group health plans will be phased out over three years. [, 6/22/10]   


No child should go without the health insurance or health care they need, yet every year, too many Delaware children are denied health coverage due to a medical condition they are either born with or develop as they grow. [, 6/22/10]  The Affordable Care Act prohibits health insurance plans from denying coverage to children based on pre-existing conditions.  These protections apply to all plans issued on or after September 23, 2010.


Beginning today, insurance companies cannot discriminate against children with pre-existing conditions. In Delaware, an estimated 19,500 children were uninsured because they had pre-existing conditions preventing them from obtaining health insurance coverage.  Many of these children may gain access to health insurance coverage because insurers are now prohibited from refusing them coverage due to a pre-existing condition.  Beginning in 2014, no one seeking coverage can be discriminated against because of a preexisting condition. 


The Affordable Care Act guarantees that all Delawareans can choose a primary care doctor from any available participating provider, it guarantees consumers’ right to designate any available participating pediatrician as a child’s primary care provider, and it prohibits insurers or employer-sponsored plans from requiring a referral for obstetrical or gynecological (OB-GYN)  care. [, 6/22/10]  These protections apply to all new policies or plans issued on or after September 23, 2010.


Nearly 14 percent of Delaware’s population lives in an underserved area. Beginning October 1, 2010, the law will provide funding for the National Health Service Corps – $1.5 billion over five years – for scholarships and loan repayments for doctors, nurses, and other health care providers who work in areas with a shortage of health professionals. Additionally, the Affordable Care Act invested $250 million dollars this year in programs that will boost the supply of primary care providers across the country.