In 2007, a constituent from Burbank wrote to me with an incredibly personal and painful story. After being sexually assaulted, she was prescribed a routine antidepressant by the attending physician — a prescription she filled once. Years later, she was denied health insurance coverage. The insurance company cited her depression as a preexisting condition in their denial letter. She asked me to support healthcare reform so that people like her couldn't be denied coverage in the future.
In just three years, the Affordable Care Act has expanded access to care for millions of Americans. Because of this legislation, all insurance policies are now required to provide free preventive care services, such as immunizations and diabetes and cancer screenings, that can help save lives through early detection. Women have also gained free access to more preventive services, including mammograms, prenatal care and contraceptive services. Children under the age of 19 with pre-existing conditions can no longer be denied care, and young adults can stay on their parent's insurance plans until age 26. Additionally, seniors who fall into the Medicare “doughnut hole” coverage gap will continue to benefit from the law by receiving discounts on prescription drugs.
Many important consumer protection provisions have also been in place to protect buyers from fraudulent and discriminatory insurance industry practices. Insurers are now required to observe strict antidiscrimination laws and cannot charge more based on gender or sexual orientation. Insurers are banned from imposing lifetime limits on new plans and dropping individuals if they develop life-threatening conditions. Insurers are legally required to observe the “80-20 Rule” — meaning they must spend at least 80% of the policy holder's premium on healthcare services and no more than 20% of it on administrative costs. What they don't spend must go back to consumers through rebates or lower premiums, and in fact, nearly $2.5 million in rebates went back to families in our community in 2011 and 2012.
And, of particular significance to the constituent who wrote to me in 2007, starting in January, no individual, regardless of age, will ever be denied coverage because of a preexisting condition.
On Oct. 1, California took a historic step forward by launching a health insurance exchange, Covered California. The Covered California marketplace is a new way to shop for health insurance — online, on the phone or in person. Consumers are now able to compare insurance plans on an apples-to-apples basis according to price, quality and benefits, and choose the plan that best fits their needs and budget. Insurance companies are now more incentivized than ever to offer consumers better products at lower prices than their competitors.
If you are without health coverage, you have the opportunity to get covered at an affordable price and will be able to choose from a variety of quality insurance plans that cover all essential health benefits like emergency services, maternity care and preventive care. I encourage you to visit the website to see if you qualify for premium assistance, federal subsidies or Medi-Cal assistance to help pay for coverage. If you would like to find out more about enrollment in Covered California or how the Affordable Care Act works, you can also visit my website, schiff.house.gov, for more information.
Improving the way our nation delivers healthcare was not a simple undertaking, and provisions of the Affordable Care Act will need to be adjusted as we move forward. I am committed to taking whatever steps are needed to improve the functioning of this significant reform and invite your comments and feedback on how the ACA has affected your family and any ideas for change.
REP. ADAM SCHIFF (D-Burbank) represents the 28th Congressional District in the House of Representatives, which includes many communities throughout Los Angeles, Burbank, Glendale and La Cañada Flintridge.