Kathleen Sebelius: Why the Affordable Care Act is good for Kansas

10/20/2013 12:00 AM

10/18/2013 6:14 PM

For the past 3 1/2 years, opponents of the Affordable Care Act have made misstatements about what would happen to families, to seniors, to employers and to health care costs as a result of the historic law. In spite of their predictions being so wrong, the attacks continue. So it’s important to give a snapshot of what health benefits the law has already produced for Kansans and what the new health insurance marketplace means for qualified residents in the Sunflower State.

Let’s start with the 86 percent of Kansans who already have health coverage. Since March 2010, when the law was signed, 448,000 Kansas seniors on Medicare have benefited as costs have been held down in historic fashion – national cost growth has been constrained to the slowest rate in nearly 50 years. Furthermore, seniors now have an annual wellness visit and preventive care, such as cancer or cholesterol screenings, with no co-pays, as part of their new Medicare benefits under the ACA.

About 25,000 young Kansas adults who would otherwise be uninsured now have insurance on their parents’ plans, and the parents of the 166,500 Kansas children with pre-existing health conditions no longer fear an insurance company denying their child health insurance, thanks to changes under the law. Most health plans now include preventive care for adults and children – from immunizations to cancer screenings, with no co-pays or deductibles – to try to help people stay healthy.

More than $4 million in refunds are being sent from insurance companies to 83,700 Kansas customers this year, because under the new law, health insurance companies now have to spend at least 80 cents of your premium dollar on health services, rather than on administrative costs or ad campaigns.

No one who has affordable employer coverage, or Medicare or Medicaid, or veterans’ health benefits has to change plans through the new Marketplace.

The 327,000 Kansans who have no health coverage – and those who purchase insurance in the individual markets – have new choices and some financial help. These are people who were often locked out of the market with a pre-existing condition or priced out with rates that skyrocketed year after year.

In case you wonder why this is important (or why anyone really needs health insurance), I want to share what Roy Jensen, the director of the Kansas Masonic Cancer Research Institute at the University of Kansas, shared with me and his fellow cancer researchers during a recent meeting: If you are uninsured and diagnosed with cancer, the research shows that you are 60 percent more likely to die within five years than if you’re insured. That’s a pretty powerful endorsement for health insurance.

There’s no doubt that the Oct. 1 launch of the marketplace website was frustrating for way too many people. We’re working hard to make sure that HealthCare.gov is easy to use and understand. Many improvements have already been made and more are coming. Clearly, Americans are eager to know the facts about their new options and how they can get health security for themselves and their families.

To be clear – no one is losing access to health benefits in these early days. There’s a 26-week open enrollment period through March 31, 2014. And plan benefits don’t begin until Jan. 1, 2014 – so as long as you are signed up by Dec. 15, you’ll have coverage on the first possible day.

There’s also a toll-free hotline, open 24 hours a day and seven days a week, with trained representatives able to answer questions in 150 languages and to help you sign up for a plan. The number is 800-318-2596.

Additionally, there are trained workers at community health centers and in neighborhoods throughout Kansas to answer questions and assist with enrollment.

In Kansas, there are now multiple private insurance companies offering competitive plans. Kansas rates are significantly lower than predicted, and lower than rates in most parts of the country. So farm families and self-employed Kansans, entrepreneurs and workers who have no health coverage through their jobs can now shop for new insurance, and many will qualify for some financial assistance with paying their premiums. No one can be denied health insurance because of a pre-existing condition, and women will no longer be charged more than men just because they are women. Kansans have choices among plans, and insurance companies now have to compete for their business based on price and service.

Kansas Insurance Commissioner Sandy Praeger has been holding town hall meetings throughout the state, joining health care providers and local elected officials and neighborhood leaders, to answer questions and get people information about what benefits and health security they are entitled to receive under the law.

In addition to the new marketplaces, the ACA provides funding for states to expand Medicaid. In Kansas, 169,000 people could be covered. But many will have no affordable option if the state doesn’t act.

We’re currently working with Republican and Democratic governors in the neighboring states of Iowa, Missouri, Arkansas and Colorado to expand Medicaid eligibility for the lowest-income working adults. The federal government is committed to paying 100 percent of the costs for the first three years and no less than 90 percent thereafter. This would mean $3 billion in federal funding for Kansas in the first seven years, to pay for the health benefits of Kansans who currently are uninsured.

Medicaid expansion is fully paid for, doesn’t add a dime to the federal deficit, and is supported by Kansas hospitals and many business leaders, such as the Kansas City Chamber of Commerce, because independent studies project that as many as 4,000 Kansas jobs would be created and more than $3.5 billion would be generated in the state’s economy.

The ACA has already produced benefits for Kansans enrolled in Medicare and employer coverage, and it has slowed the growth of health costs for everyone. In football terms, we’re early in the first quarter, and while our opponents want to declare “game over,” I’m confident that by the end of open enrollment, we’ll have millions of Americans, and thousands of Kansans, with health security that they never thought was possible.

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