Opinion Columns & Blogs

Care act filling gaps

The following was edited from Health and Human Services Secretary Kathleen Sebelius' remarks last week in the Landon Lecture Series at Kansas State University:

The most significant health legislation passed in the last 45 years is the Affordable Care Act, signed into law this March. And it lays the framework for reorganizing health care as well as reforming our health insurance system.

For years, we have had a health insurance market that was crumbling.

Employers were dropping coverage. Premiums were skyrocketing. Consumers were getting more and more frustrated. And more Americans were shut out, priced out or dropped out of the market altogether.

Without health insurance or with insufficient health insurance, too many Americans went without critical care. Or saw their life savings disappear with one accident or illness.

And without legislation, the market would have kept deteriorating.

So over the past eight months, our department has been working closely with governors like Mark Parkinson, and insurance commissioners like my friend Sandy Praeger, as well as the health care community and consumer and employer groups, to implement the first parts of the new law.

And while we've got a long way to go, you can already see signs of progress right here in Kansas.

In the past eight months, we've begun addressing one of the unacceptable gaps in our health insurance system — the so-called doughnut-hole gap in insurance coverage for prescription drugs for seniors — by mailing $250 checks to almost 19,000 Medicare beneficiaries in Kansas. In 2011, seniors will get a 50 percent discount on brand-name drugs. And eventually, we'll close that doughnut hole completely.

We've also established an Early Retiree Reinsurance Program that helps employers maintain health coverage for their early retirees. Right now, a lot of retired folks aren't yet eligible for Medicare, and rely on their former employers for health insurance.

But as health costs have risen, more and more employers are ending this coverage, which leaves folks in their early 60s with nowhere to go. And individual coverage for a 60-something can be very expensive. So far, 34 major Kansas employers and unions from Spirit AeroSystems to Sprint Nextel have applied to be part of this program to keep their retiree coverage in place.

With support from our department, Kansas has also set up a Pre-Existing Condition Insurance Plan where Kansans who had been shut out of the health insurance market because of their medical conditions can get affordable coverage.

We've also created a new Patient's Bill of Rights that establishes some long-overdue consumer protections in our health insurance market.

For example, insurance companies are no longer allowed to take away someone's insurance when they get sick just because of an unintentional mistake in their paperwork.

Finally, there's one reform that's especially important for students. As part of the new law, young Americans who don't get insurance from their jobs can stay on their parents' plan until their 26th birthday.

So whether you're still looking for a job after graduation, or going off to graduate school, or working for a small business or nonprofit that doesn't offer health insurance, you won't have to worry about losing your health coverage.

Now, these reforms are not going to fix every problem in our health insurance system overnight. In fact, because we didn't want to disrupt the coverage people already have, many of the most important changes won't take effect until 2014.

But we're starting to fill in some of the biggest gaps, end some of the worst abuses and give some more control to all the people who felt like there was nothing they could do when their premiums went up 30 percent or their claims were denied.

And as we go forward, I can tell you that we're going to keep working with all of our state partners to implement this law effectively and improve it where we can.