Baucus, Lindeen Announce Key Health Care Protections For Montana Families

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Senator, State Insurance Commissioner Tout Important Consumer Protections Taking Effect Today on Six Month Anniversary of Health Care Law

WASHINGTON, D.C. – Montana’s senior U.S. Senator Max Baucus and Montana Insurance Commissioner Monica Lindeen today announced the implementation of important consumer protections under the new health care law that will ban private insurance company abuses and provide Montanans with the insurance security and choices they deserve. These provisions, including an end to discrimination based on pre-existing conditions for kids and free coverage for preventive services, took effect today on the six-month anniversary of the Affordable Care Act becoming law.

“The provisions going into effect today put consumers and their doctors – not insurance companies – back in control of their health care,” Baucus said. “These critical consumer protections will ensure Montanans have real choices when it comes to their health insurance coverage and the peace of mind of knowing that coverage will be there for them when they need it. The new health care law protects Montanans by ending egregious insurer practices like dropping coverage for people when they get sick and denying coverage to kids with pre-existing conditions. The law also allows young adults to stay on their parents’ health plans longer and guarantees free coverage for preventive care like mammograms and vaccinations. And the law guarantees consumers the right to a meaningful appeals process to hold insurance companies accountable. These benefits are what Montanans have a right to expect when they pay their health insurance premiums each month, and with these protections, these are the benefits Montanans are guaranteed to receive.”

“Today is an important milestone as early provisions of health care reform begin to take effect,” Lindeen said. “Finally, consumers are getting the quality products and services they expect from insurance companies. These protections will help all Montanans, from those with the most health care needs to those wanting to maintain their good health. By eliminating pre-existing condition exclusions for children, the new law allows parents to take care of their children’s health needs at a reasonable cost. I am proud to be implementing these reforms for the working families in Montana.”

Thanks to the consumer protections implemented today:

  • Insurance companies can no longer deny coverage for kids who are sick;
  • Insurance companies can no longer arbitrarily drop coverage or deny claims for patients when they are sick and need it most;
  • Insurance companies are required to allow kids to stay on their parents health insurance plans until age 26;
  • Insurance companies are required to cover all recommended preventive care and immunizations under all new plans with no out-of-pocket costs or co-pay for patients;
  • Insurance companies are banned from limiting the amount of coverage patients can receive over their lifetime and from unreasonably restricting coverage each year;
  • Insurance companies are required to provide consumers in new plans with an independent, fair appeals process that will work for them;
  • Insurance companies have to allow patients in new plans the freedom to choose their primary care doctor, not require authorization for a woman to see her ob-gyn and ensure access to emergency care; and
  • Insurance companies cannot discriminate against workers based on how much money they make.

As Chairman of the powerful Senate Finance Committee, Baucus was instrumental in passing these provisions to protect Montana consumers. As Insurance Commissioner, Lindeen has played a vital role in implementing these important consumer protections in Montana. And these protections are making a real difference in the lives of Montanans.

Already, nearly 26,000 Montana businesses are eligible for tax cuts to help them provide health insurance for their workers. Matt Hisel, is the owner of one of these small businesses in Missoula and a member of the Montana Small Business Alliance.

“The tax cuts Max worked to pass in the health care law will make a real difference in our ability to afford health insurance for our workers and their families,” Hisel said. “And the relief these tax cuts provide will make it easier for us to hire new workers as our business grows.”

The provisions enacted under the health care law today will also make a real difference in the life of one of Hisel’s employees, David Hutchins. Hutchins’ young son Elijah has leukemia and down syndrome and can’t get coverage under private insurance because of these pre-existing conditions. Luckily, Elijah is able to qualify for Medicaid because David is only working part-time while attending school. But if his income were to increase, Elijah would lose his coverage. Thanks to the new health care law, starting today, private insurance companies will no longer be able to discriminate against Elijah and he will be guaranteed access to the coverage he needs.

“Before today, I worried about what would happen to my family if we lost our coverage under Medicaid,” Hutchins said. “By requiring health insurance companies to do the right thing and guarantee coverage for kids like my son, the new health care law has lifted a huge burden from my family.”

Karen Moses is a proud mother of three from Billings and a former member of the school board. Her son recently graduated from college and has been coping with type 1 diabetes since he was ten years old. Like many recent college graduates these days, Moses’ son is looking for work in today’s tough economy, and the new provisions taking effect today will ensure Moses can keep her son insured under her plan until age 26.

“Each and every day insurance can help us at least keep the bills at bay is significant; each and every day my son has access to insulin, needles and test strips, he lives — it’s that simple. Each additional day is a blessing and this new law will help our family breathe easier, knowing my son will be able to keep his insurance coverage for the care he needs,” Moses said.

Additionally, thousands of Montana seniors have already received rebate checks to help them cover the costs of prescription drugs in the so-called donut hole, a coverage gap in the Medicare Part D prescription drug plan. Montana was also one of the very first states to have its new high-risk pool up and running, to provide affordable health insurance choices for Montanans who have been denied coverage because of a pre-existing condition such as diabetes or cancer. And the Montana Commissioner’s office was awarded a significant grant to help the state improve oversight of insurance companies and crack down on premium rate hikes.

The Commissioner’s office has also set up a council of stakeholders to provide input on the development of Montana insurance exchanges, which will provide one-stop shopping where families and small businesses can quickly and easily view and compare health insurance policies and receive tax cuts to help them afford coverage. And the policyholder services divisions is prepared and ready to help Montana consumers take advantage of all the benefits of the new law and answer any questions Montanans may have.

The Commissioner’s office is currently moving on legislation to codify the new consumer protections in Montana and allow the office to penalize private insurance companies who commit abuses at the state level.