Baucus, Lindeen Examine Benefits of Affordable Care Act

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Senator, Insurance Commissioner Discuss Ways to Make Health Care Reform Work Even Better for Montanans as New Benefits Continue to Take Hold

WASHINGTON, D.C. – Montana’s Senior Senator Max Baucus and Montana Insurance Commissioner Monica Lindeen met today to discuss ways to help even more Montanans take advantage of the benefits already available under the Affordable Care Act and examine the next steps toward implementing further cost-savings and consumer protections set to take affect by 2014. Among the many benefits Montanans are taking advantage of already, yesterday the Centers for Medicare and Medicaid services announced that 704 Montana seniors have received an average discount of $820 on expensive prescription medicines so far this year, a total of almost $580,000 in savings statewide.

“Montanans are already beginning to take control of their health care back from insurance companies, with the security of knowing they are protected from abuse, and small businesses owners across the state have access to tax cuts to make health insurance more affordable. Insurance Commissioner Lindeen and her team have done and incredible job putting the benefits of the Affordable Care Act to work for Montana,” Baucus said. “We’ve got a lot more work ahead of us to continue putting all the cost-saving measures and consumer protections in this law in place to reduce the deficit and lower costs for working families. And, we’ve got to do more to help all Montanans understand what’s in the law so they can take advantage of the benefits. Moving forward, I’ll keep working with Monica and listening to all Montanans to help boost what’s working and fix what isn’t.”

“We’ve made a lot of progress in the year since health insurance reform became law,” said Lindeen. “For the first time, insurance companies can’t deny coverage for kids with illnesses and seniors no longer have to worry about hitting their lifetime cap. Over the next few years, we’ll see many more commonsense reforms that protect Montana families, and my office will do everything we can to make health insurance work for Montana.”

Montanans are already beginning to reap the benefits of the Affordable Care Act, including billions of dollars in tax credits that up to 26,000 Montana small businesses were eligible for this year to help them provide insurance to their employees, free preventive care, help with expensive prescription drugs for seniors, and important protections from insurance companies detailed below. Montana was also one of the very first states to set up a new high-risk pool to provide affordable health insurance choices for Montanans who have been denied coverage because of pre-existing conditions like diabetes or cancer. Lindeen’s office was awarded a significant grant to improve oversight of insurance companies. Equipped with improved tools and resources, Lindeen and her staff are ready to help Montana consumers take advantage of all the benefits of the new law and answer any questions Montanans may have.

Montanans now enjoy the following protections from insurance companies thanks to the Affordable Care Act:

  • 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.

Further consumer protections and cost-saving measures to be implemented by 2014 include:

  • The establishment of insurance exchanges, that will serve as one stop shops where consumers can quickly and easily compare insurance plans and determine their eligibility for tax cuts. Members of Congress will shop for insurance in the very same exchanges as consumers in their states;
  • Small business exchanges that allows small businesses owners to reduce their costs and increase their buying power by pooling together like large companies do today. No small businesses with fewer than 50 employees will be required to provide health insurance;
  • Banning insurance companies from discriminating against anyone for a pre-existing condition like cancer or diabetes; and
  • A requirement that insurance companies spend at least 80 to 85 percent of premium dollars on providing health care to Montanans rather than salaries and bonuses for CEOs.

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