New Report Says Health Care Reform Law Protects 105 Million Americans from Caps on Coverage

Once upon a time, lifetime limits on health care coverage were a common practice. A Kaiser Foundation study reported that up to 59% of health insurance plans in 2009 had some sort of lifetime limit policy in their insurance plans. Lifetime limits on coverage is unlikely to result in a happy ending – especially if a family member under the plan is faced with a severe illness – but now, thanks to the Affordable Care Act (ACA), this practice is prohibited.

A recent report by the U.S. Department of Health and Human Services (HHS) indicates that families and children now enjoy improved coverage by having no lifetime limits in their health plans. According to the report, although some plans already had no lifetime coverage limit, 27.8 million more American children don’t have to worry about reaching lifetime limits on coverage. In Wisconsin, 580,000 children are protected from having lifetime limits on coverage – thanks to a ban on this practice, under the ACA.

On a broader scale, the HHS statement, released March 5th, also announced that 105 million total Americans – children, men and women, alike – now benefit from this increased consumer protection in health care. Other protections for children and families in the health insurance market also continue to be implemented, including annual coverage limits – which are being phased out.Although the ACA has already prohibited lifetime limits on coverage, annual dollar limits on coverage will be eliminated in 2014. In the meantime, the annual limits are being increased, according to the following schedule.  Under the ACA, health care plans cannot set an annual dollar limit lower than:

• $750,000 for a plan year starting on or after September 23, 2010 (but before September 23, 2011).
• $1.25 million for a plan year starting on or after September 23, 2011 (but before September 23, 2012).
• $2 million for a plan year starting on or after September 23, 2012 (but before January 1, 2014).

Protecting families and children from health care practices that result in being unable to receive adequate care is, and should be, a top priority in health care reform. We are glad to see such consumer protections continue to take effect – and continue to benefit Wisconsinites – allowing for this story to take a turn for the better. Check out how this provision is helping Wisconsin women, here.

Lacy Langbecker