by John Garamendi,
If you tuned into the Rachel Maddow Show last night, you know that major health care provisions in the Patient’s Bill of Rights take effect today. You also know Gail, the woman in this video. She’s an amazing person whose life was immensely improved because President Obama and the Democratic Majority in this Congress fought tooth and nail for health care reform that puts patients first.
Gail was told by her doctor, “Either you dip into your retirement fund, or you’re going to die.” Because of health care reform, she can now choose to live and keep her retirement. Gail, previously denied coverage because she has a pre-existing condition, was able to enroll in a temporary high-risk pool to receive the cancer treatment she needs and deserves because of the Patient’s Bill of Rights. By 2014, no insurance company in the nation will be allowed to deny her care.
Gail is one of millions of Americans who know firsthand that the need for health care reform was and continues to be a life and death priority.
I recently met Violet, a gregarious two-year old girl born at Contra Costa County Regional Medical Center near my district. She was born with a rare – and costly – form of epilepsy. Under the old system, she was at risk of reaching her plan’s lifetime and annual coverage limits by the age of four, and there was little stopping her insurance company from finding trivial excuses to kick her off her coverage. As of today, the Patient’s Bill of Rights guarantees that lifetime coverage limits and rescissions are banned in all new plans, and annual limits are being stretched over a three-year flexible period until they are completely eliminated by 2014.
At an assisted living home in Livermore, a city in my district, I met many residents at risk of entering the Medicare Part D prescription drug “donut hole” coverage gap. They will receive a $250 rebate check this year as we transition to the complete closure of the prescription drug coverage gap by 2020.
At that same home, I met seniors who immediately were able to access free preventative care in Medicare. As of today, key preventive health care is available without co-pays or deductibles for every American entering a new plan. If your insurance company tries to deny you coverage recommended by your doctor – and we know sharks at the insurance companies will certainly try – you now have the right to seek an independent appeal from an outside watchdog.
(I hope it gives you some comfort to know that the new Director of the Division of Enforcement in the Office of Oversight at the Department of Health and Human Services’ Office of Consumer Information and Insurance Oversight is Gary Cohen, my former Chief Legal Counsel at the California Department of Insurance. He worked with me to build the toughest consumer protection agency in America, and I look forward to watching Elizabeth Warren and him compete for the honor of that claim in the years ahead.)
I met a courageous young girl and her parents at my El Cerrito town hall. They had insurance through her father’s job, but they were terrified that if he was ever laid off, her pre-existing condition would prevent her from getting coverage. As of today, she can stay on his plan up to the age of 26.
That girl, intelligent and full of life, is also eligible for the high-risk pool, and we designed the law to guarantee her access to an individual plan. I end on this note, because it provides a constructive lesson in what still needs to happen. We learned yesterday that major insurance companies, including Anthem Blue Cross, Aetna, and Cigna, plan to stop offering children’s-only health plans instead of obeying the new Patient’s Bill of Rights that requires companies to offer health insurance to children. That is unacceptable.
We created the most pro-consumer, pro-patient framework for health care delivery ever in the history of our great nation. With some of the reforms, the insurance companies backed down and accepted that their insatiable greed would be restricted. With other changes, like children’s coverage, some of the greediest insurance companies continue to try and skirt around the rules. Our work is never done, but as we address the abuses of the insurance companies, the Patient’s Bill of Rights really continues helping real people.
Congressional Republicans have pledged to repeal and defund the Patient’s Bill of Rights. They have pledged to take away vital patient protections and put insurance companies back in charge. We can’t let the Republicans tear down all that’s been accomplished for Gail and the millions of Americans like her.
Congressman John Garamendi served eight years as California's Insurance Commissioner, where he was widely credited for creating the best consumer protection agency in America. He authored a near-universal health care bill that was a key inspiration to President Bill Clinton's health care proposals in the early 1990s.