FRIDAY, July 16 (HealthDay News) -- Seniors whose drug costs
push them into Medicare's "donut hole" and parents whose children
are uninsurable due to pre-existing health conditions are among the
first Americans to see tangible effects of the nation's historic
health reform law.
The public is still split -- pro and con -- over the
comprehensive health legislation, polls show. But as the first
provisions of the Affordable Care Act begin to take effect,
consumer sentiment appears to be on the upswing. The percentage of
Americans with a favorable view of the law jumped 7 percentage
points to 48 percent in June, according to the latest polling data
from the Kaiser Family Foundation. Forty-one percent have an
"From an individual [standpoint], there's a lot that could be positive," said attorney Chantel Sheaks, a principal in the Washington, D.C., office of Buck Consultants, a benefits consulting firm.
The law, for example, requires individual and group insurers
that cover dependents to extend that coverage to adult children
until the age of 26.
"For a lot of parents, that's very positive, especially given this economy where younger adults are having difficulty finding jobs -- and finding jobs that actually have good benefits," Sheaks said.
Like many of the law's early provisions, the age-26 requirement
takes effect on or after Sept. 23, 2010. For health insurance plans
that operate on a calendar year, new benefits typically would take
effect on Jan. 1, 2011. However, some insurers are extending health
insurance to young adults ahead of the deadline, says the U.S.
Department of Health and Human Services (HHS).
The sweeping health overhaul signed into law by President Barack
Obama in March sets in motion a series of reforms that will be
carried out over the next several years. Core elements of the
reform package, including the creation of state health insurance
exchanges and the availability of premium subsidies for low-income
individuals and families, don't take effect until 2014.
Numerous states have filed suit or introduced legislation
seeking to block the federal law or provisions of the legislation.
A key sticking point is the requirement that most individuals
obtain health insurance coverage or pay a penalty.
Virginia Attorney General Ken Cuccinelli contends that the
federal government's mandate overreaches its authority. A federal
judge is expected to rule by the end of the month on a U.S.
Department of Justice motion to dismiss the state's lawsuit,
The Roanoke Times reported. The Justice Department has filed
a similar motion in a case brought by the state of Florida and
joined by 19 states and the National Federation of Independent
Missouri Lt. Gov. Peter Kinder is the latest to join the fray.
His suit, filed July 7, alleges that the law will drive up the cost
of health care in Missouri and force people to purchase coverage
they don't want or need.
Meanwhile, many employers and insurers are moving ahead with
implementation of the law. Here's how some of the initial
provisions are shaking out:Seniors with sizable drug costs
The federal law begins phasing in plans to close the "donut
hole," the gap in Medicare Part D coverage during which older
Americans must pay 100 percent of their drug costs. As a first
step, the federal government is sending every eligible senior who
reaches the gap this year -- an estimated 4 million people -- a
check for $250.
The first round of tax-free disbursements went out last month. A
second round of checks was mailed last week, and those mailings
will occur monthly throughout 2010 as seniors hit the donut hole,
HHS says.People with pre-existing health conditions
By 2014, the law prohibits insurers from discriminating against
adults with pre-existing conditions. In the interim, adults who
have been uninsured for at least six months and can't get insurance
because of a medical condition may enroll in a "Pre-Existing
Condition Insurance Plan."
HHS began offering these plans in 21 states on July 1. The
remaining 29 states are operating their own plans and will begin
enrolling people by the end of the summer.
A separate provision, effective Sept. 23, does away with
pre-existing condition exclusions for children.
For those who had tried to purchase individual insurance until
now, there were "huge issues with trying to find coverage for
people who have health problems, and that is absolutely true for
children," said economist Genevieve M. Kenney, a senior fellow at
the Urban Institute in Washington, D.C. "Yes, maybe you would be
able to get a policy but it might exclude the very health problem
that the child suffers from."
Banning pre-existing condition exclusions won't affect a large
number of kids, she said, but it will be a substantial benefit to
children who currently don't have access to coverage that meets
their needs.People with significant medical costs
Effective Sept. 23, insurers may no longer place lifetime dollar
limits on essential benefits. The law also restricts annual limits
"For those people who had catastrophic accidents, cancer, this is very important, and I think for security and peace of mind
for people who may not have reached those limits, but know that
they're there, that you'd be protected," Sheaks said.
And regulations issued Wednesday now require new private health
plans to cover preventive services such as blood pressure tests and
cancer screenings with no cost-sharing requirements for
To learn more about the impact of the Affordable Care Act, visit
U.S. Department of Health and Human Services Web