ACA matters for those with disabilities

Published 5:15 pm Saturday, September 21, 2013

The Arc, the nation’s leading and largest organization for people with intellectual and developmental disabilities (I/DD), has been a leader of the charge for health insurance reform in the disability community, calling for the elimination of coverage exclusions for pre-existing conditions, ending discrimination in health care, expanding Medicaid eligibility, and promoting universal health care coverage.

Although health care reform is designed to benefit all Americans with or without specific disabilities, many people with I/DD are impacted by one or more of these issues, suffering disparities in health care compared to their peers without disabilities.

For various reasons, people with I/DD may not get the preventive or comprehensive care they may need and advocating for health care reform is an important part of what The Arc does at a national level.

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While progress has been achieved over the years, comprehensive health insurance reform was an elusive goal until the passage of the Affordable Care Act (ACA). Thanks to this important legislation, today we enjoy the major benefits:

•Children can access health insurance now that was previously denied because of a pre-existing condition (this extends to adults in 2014). A pre-existing condition is one that existed before health coverage began and can include conditions that many people with I/DD have including seizures, diabetes, asthma and other conditions.

•Young adults can stay on their parents private health insurance plan until they turn 26, which is beneficial for many people with I/DD who may have a longer transition period from youth to adulthood.

•Access to free preventive care — like mammograms, colonoscopies, and other testing.

•Health insurance companies can no longer arbitrarily place a life time limit on health insurance coverage and annual limits are being phased out, which can be crucial to many families with a member with I/DD who also experiences complex and lifelong medical needs such as compromised breathing or swallowing or difficulty walking. The cost of addressing these medical needs through surgeries, therapies, medical equipment and/or prescription drugs can add up very quickly for individuals and families.

•In 2014, the health insurance landscape will dramatically change as reforms to health insurance practices will mean that companies cannot deny coverage or charge more to provide insurance coverage to people with health conditions. New health insurance coverage options will be available as states decide whether to expand Medicaid to 133 percent of the federal poverty level (in 2013, 133 percent of federal poverty level is $15,282 for an individual and $31,322 for a family of four) and private health insurance marketplaces (formerly known as exchanges) begin operating for consumers to find the best insurance for them.

These private insurance marketplaces will allow small businesses and individuals in need of affordable health insurance to easily find coverage that can fit in their budgets. Low and moderate income families will have help in affording the insurance.

As we approach the next milestones in ACA implementation, The Arc will continue to develop materials and update our website to explain key provisions of the ACA in order to help people with I/DD, their family members, our chapters, and our supporters understand how the law can benefit them. Visit www.thearcmc.org, or The Capitol Insider Blog http://insider.thearc.org/category/health-care. Up to date information about how to enroll and answers to other questions can be found at www.healthcare.gov or by calling 1-800-318-2596 any time.