So, the bill passed. Some here in Portland believe that this bill somehow robbed them of the freedoms for which their ancestors fought and died, some are afraid that it might mean paying more taxes, some worry about how they will afford the mandated coverage, and still others are disappointed that a public option wasn't included. Whatever you think of the bill, though, if you are the parent of a child with special needs, I wanted to talk to you about some of the changes that go into effect in the next six months.
Follow me below the fold if you'd like.
It used to be that if you got sick enough that your insurance carrier didn't want to cover you anymore, they would go through your records and try to find a reason to discontinue coverage. If they could find anything (a misspelled name, an out-of-date address) they'd drop you like a hot potato. If your child has ongoing, chronic, or otherwise expensive issues, there was a chance that the company was going to decide to just stop covering them. In six months, they won't be able to do that anymore.
It used to be that if your child had ongoing, chronic or otherwise expensive issues, there was a good chance you'd meet your annual coverage cap. Barring that, the chances are good that your child would reach their lifetime benefit cap in a few years. These caps meant that a child could undergo something drastic (like a heart transplant), and then recover fully but if in ten years they were hit by a drunk driver, the insurance company could deny them coverage. "I'm sorry," they could say, "but we've already paid all we think your child's life is worth." In six months, they won't be able to do that anymore (except in special cases of annual caps, and in 2014 they wouldn't be able to do it at all).
It used to be that if you had to make sure that your children were covered from birth, because if a child with special needs ever had a lapse in coverage, they could be denied a new policy. Kids born on Medicaid, or whose parents lost their jobs and couldn't afford COBRA, could end up un-insurable for the rest of their lives. Insurers simply didn't want to take on those kids with ongoing, chronic or otherwise expensive issues, and so simply refused to cover them. In six months, they won't be able to do that anymore.
It used to be that when your child turned 18, they had to find their own insurance. The only way out of this was to enroll said child in college full-time, in which case they could remain on your insurance until they were 24 years of age. If they failed classes, or if their special needs kept full-time post-secondary education out of their grasp, the only hope was that their ongoing, chronic or otherwise expensive issues classified them as disabled enough to qualify for Medicare or poor enough for medicaid. Otherwise, the insurance companies were going to drop them, and they'd be on their own. In six months, the drop-off age will be 26, regardless of schooling status.
There are all sorts of other things that are changing in the next six months, from shrinking the Medicare Part D donut hole to funding more community health centers, to tax credits for small businesses. These affect all people who are low income, self-employed, elderly, disabled, mentally ill or in some other way are uninsured or underinsured. For the parents of kids with those ongoing, chronic or otherwise expensive issues, though, it basically comes down to a few important things.
In six months, insurance companies can't:
take your child's coverage away just because they are ill
place restrictive and arbitrary caps on how much care your child can
have
classify your child as un-insurable because of a pre-existing condition
kick your child off your plan as soon as they reach 18 years of age
The bill isn't perfect, by a long shot. It is however, a step forward for the parents of kids whose medical files weigh more than most newborns. It means that instead of panicking about filing bankruptcy or losing our homes while our children are in the hospital, we can focus on helping them heal and recover. No insurance company should be allowed to condemn a child to death because that kid's care cuts into their profit margin, and in six months, they won't be able to do that anymore.
X-posted for the Portland Special-Needs Kids' Examiner. I thought about putting it over at the Big Orange Satan, but I'm scared to go over there anymore.
I'm a long time lurker and rare poster here. This is my take on the whole health-care bill kerfluffle. Perfect? No. Good for kids like mine, Gigi's, Lyn's and others? Yes.