August means new ACA benefits..

Californians will start getting more help in accessing and affording health care this week, as a result of new benefits from the Affordable Care Act.
* Starting this week, August 1, around five million California women will now have free access to eight key preventative care services, as a result of new benefits stemming from the Affordable Care Act. 
* Also, as many as 1.9 million Californians will be get rebate checks totalling $74 million in the next week, as a result of the ACA’s implementation.

While hundreds of thousands of Californian already have new coverage, millions have new financial help in getting care–whether it is help with their premiums, or removing the co-payments that sometimes serve as a barrier to needed preventative care. More benefits will be available in 2014, but these are important steps toward an improved health system.

The new preventative services that insurers now must cover without cost-sharing include:

  • Well-woman visits.
  • Gestational diabetes screening that helps protect pregnant women from one of the most serious pregnancy-related diseases.
  • Domestic and interpersonal violence screening and counseling.
  • FDA-approved contraceptive methods, and contraceptive education and counseling.
  • Breastfeeding support, supplies, and counseling.
  • HPV DNA testing, for women 30 or older.
  • Sexually transmitted infections counseling for sexually-active women.
  • HIV screening and counseling for sexually-active women.

The rebates are the result of the new “medical loss ratio” that ensures that at least 80% of premium dollars must go to patient care, rather than administration and profit. Health Access worked at the National Association of Insurance Commissioners to ensure strong oversight over the plans, and in passing SB51(Alquist) in 2011 to put these protections in state law.

Ideally, we want premiums to come down, rather than consumers to get a rebate after the fact–but the check is a symbol of the new oversight over the industry, to ensure patients got the best value for their premium dollar.

California has aggressively sought to take advantage of the Affordable Care Act. As a result of the law and California’s implementation, many Californians have benefited, including:
·         Over 12,000 Californians denied for “pre-existing conditions” now have coverage through the Pre-Existing Condition Insurance Program (PCIP).
·         Over 415,000 Californians now get coverage through county-based Low-Income Health Programs, and will be part of 2 million to be newly eligible for Medi-Cal coverage in 2014.
·         Over 355,000 California young adults who now get coverage through their parents’ health insurance.
·         Over 319,000 California seniors who saved over $170 million dollars in prescription drug costs in 2011.

These new August benefits are not the end–many more come online leading up to 2014. But much more work remains to be done in regards to implementing and improving upon the new health law in order to further improve security of coverage, increase access to coverage regardless of health status, and secure and expand coverage options in 2014.

Health Access California promotes quality, affordable health care for all Californians.