|By Timm Herdt, Ventura County Star, Calif.|
|McClatchy-Tribune Information Services|
Here's the concept: When consumers buy insurance, they should get a product of value that covers the essential health care services they need and expect it to cover.
Forget contraception for a moment and think about its flip side: maternity.
But for now, this is the reality for women of childbearing age when they shop for insurance: The most likely significant health care cost they will incur is pregnancy, but it's entirely possible that the insurance they buy will cover neither the cost of preventing pregnancy nor the costs of delivering a baby.
For them, having such an insurance policy is akin to owning a car that doesn't start and has no brakes. You make the car payments every month, but still have to ride a bus to work.
As Friday's second anniversary of the Affordable Care Act -- you may know it as "Obamacare" -- approaches, consumer advocates are reminding people that one of the benefits of health care reform is that it ensures that insurance policies actually provide the services for which consumers believe they are paying.
"People really don't know what they've got," said
"A very important part of the Affordable Care Act is getting rid of the fear of fine print that so many consumers have -- the fear that they will fall through a loophole," said
Such "loopholes" can be of much greater financial consequence than, say, having to pay out of pocket each month for a prescription for The Pill.
As a couple in their late 20s, the Strongs purchased a very good health insurance policy with a lifetime benefit limit of
Most children with SMA don't survive beyond age 2.
"My daughter is an outlier," Strong told me Tuesday. "We're lucky to have her with us still."
Gwendolyn is completely paralyzed, and any minor illness threatens to shut down her respiratory system. She has 24-hour care at home, and that, coupled with her frequent visits to hospital intensive care units, runs up medical bills of about
Before the law passed ending lifetime limits on insurance benefits, Strong said that "every day she remained alive we marched toward a cliff. We were very quickly headed for financial ruin."
Beginning in 2014, the Affordable Care Act will limit annual out-of-pocket costs at
Speaking this week at a news conference promoting a bill that would accelerate that requirement by one year in
"For many medical conditions, we've seen an increasing number of medications that for the very first time can slow or prevent regression," said Dr.
At its core, that's what the Affordable Care Act is about: making certain that when Americans purchase health insurance they will receive a product that delivers what they're paying for -- the peace of mind of knowing that if catastrophe strikes they will be protected.
"It really can happen to anyone," Strong told me. "You don't think about these things until you wish you had."
(c)2012 Ventura County Star (Camarillo, Calif.)
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