How Health Care Reform Affects You

A guide to the health care changes already in effect.

by Meryl Davids Landau
Photograph: Leigh Schindler

Most of the best-known provisions of the Patient Protection and Affordable Care Act of 2010 (that every American will be able to get coverage, that there will be no more exclusions for preexisting conditions, that insurance exchanges will be created for people who can’t get coverage via their employers) won’t kick in until 2014. But some big changes are already in effect or will be soon:

> No more arbitrary cancellations “Once you get sick, it’s become all too common for insurers to comb through your application for errors they can use as grounds to cancel the policy,” says Kathleen Stoll, director of health policy at the Washington, D.C., nonprofit advocacy group Families USA. This is called recision, and an average of 5,000 women are victims of it every year, according to the Commonwealth Fund, a nonprofit foundation in New York. The new law prohibits retroactive cancellation of policies except for outright fraud (in other words, if you made a small error about a date, you’re safe; if you claimed you never smoked but in fact only quit a year before acquiring your policy, that’s fraud). Another patient-friendly protection: The act bans lifetime payment limits, which hurt people who have long and debilitating diseases.

> Gap plans People with serious health problems who have been uninsured for at least six months can now buy individual “pre-­existing condition insurance plans” (PCIPs). “These full-range policies should make insurance more affordable for these people, who would otherwise be offered plans, if at all, only at sky-high rates,” says Michelle Doty, director of survey research at the Commonwealth Fund.

> Better care in your later years In January the law will make it easier to get long-term-care insurance, via the Community Living Assistance Services and Supports program. Caregiver expenses can be collected once you’ve paid premiums (still to be set) for at least five years.

> Free screenings New policies let you say good-bye to copays and deductibles for teststhat have been proved by strong research to prevent or diagnose diseases: mammograms, colonoscopies and screenings for STDs, depression and breast-cancer genes. (Find covered tests—those with an “evidence rating” of A or B—by entering your age and health risks at the government website epss.ahrq.gov.)

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