Key Health Reform Provisions to Begin Next Week: News of the Day

September 23rd marks the 6-month anniversary of the Affordable Care Act and the first day many important reforms go into effect. Beginning September 23rd, all new health plans will be prohibited from placing lifetime caps on coverage. This provision will be life-changing for one family profiled by Kaiser Health News and countless other families around the country. Kaiser reported:

“For many years, Ric and Jill Lathrop held their breath when the annual open enrollment period for their health insurance plan rolled around. Their two boys, now 12 and 14, have severe hemophilia, and each needs twice-weekly injections of a blood clotting replacement factor that costs roughly $250,000 per person per year. The couple lived in fear that their health plan would put a lifetime limit on their benefits.

“In 2005, that's what happened. The Oshkosh, Wis., hospital where Ric Lathrop worked as an MRI technician instituted a $2 million lifetime cap on benefits for the entire family. Rather than wait for their benefits to run out, the Lathrop family relocated to Illinois, where Ric Lathrop got a job at a hospital in Peoria; along with the job came insurance without lifetime limits.

“If that coverage had changed, the Lathrops might have had to move again . . . and maybe again. But the federal health-care overhaul makes further wandering unnecessary. Starting Sept. 23, the new law requires that when health plans renew their coverage for the coming year, they eliminate lifetime limits on coverage.

"It gives us a lot of reassurance to know our kids can have more freedom," says Jill Lathrop.”

Other provisions going into effect for all new plans and plan years beginning after Sept. 23 include:

  • Requiring plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy.
  • Banning all health plans from dropping people from coverage when they get sick.
  • Providing immediate access to insurance for Americans who are uninsured because of a pre‐existing condition. —This program is already in effect.

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