What Does Health Care Reform Mean for People Concerned About Colorectal Cancer?

This morning, the President signed into law the biggest transformation of our health care system in decades. The law includes a number of provisions that will help individuals diagnosed with colon or rectal cancer.

Although many of the provisions of the new law are phased in to take effect gradually until the entire law is implemented in 2018, some benefits will be available immediately.

Highlights of the provisions that will benefit individuals people facing cancer treatment include: prohibiting insurance companies from dropping patients who become sick; eliminating lifetime and annual limits on coverage; prohibiting insurance companies from denying coverage because of pre-existing conditions; and limits on on out-of-pocket expenses.

You can review a chart developed by C3 with key issues affecting colorectal cancer prevention and treatment that are part of the health care reform legislation.

While historic, enactment of this new law is just one step in an ongoing process. Even after all the provisions in the new law take effect in 2018, many Americans may be newly insured but will still fail to receive the right treatment at the right time. The Colorectal Cancer Coalition continues to support research to help develop new treatments and to support efforts to increase awareness about the importance of early detection and screening.

BENEFITS IF YOU HAVE BEEN DIAGNOSED WITH COLORECTAL CANCER:

Beginning immediately, health insurance plans cannot drop you or reduce your benefits just because you become sick, a process called rescission.
After January 1, 2014, insurance plans will not be able to deny coverage or charge higher premiums if you have a pre-existing condition. Until that time, people with pre-existing conditions will be able to find affordable insurance in special high-risk pools supported with federal funds. For people with inherited colorectal cancer who worry about testing for a genetic condition, the law specifically includes genetic information among the health conditions for which there cannot be discrimination.
Six months after the the law is enacted, insurance companies can no longer place lifetime limits on healthcare coverage, nor can they impose restrictive annual limits. In 2014, all group and individual plans must eliminate annual limits. Even if you need expensive cancer care, you will no longer need to worry about your insurance refusing to meet those costs.
Depending on your income, there will be limits on the amount of money you need to pay out-of-pocket for health care for you and for your family each year.
In 2014, uninsured people will have access to several new options including higher income limits for Medicaid and participation in an American Health Benefit Exchange. The exchanges will clearly outline costs and benefits of each health care policy so consumers can make informed choices about care. Subsidies will be available to keep costs affordable.

BENEFITS IF YOU WANT TO PREVENT COLORECTAL CANCER:

If you are privately insured through your employer or the insurance exchanges, preventive services are covered fully without your having to meet a deductible or pay a co-pay.
If you are on Medicare, cost-sharing for preventive screenings will end on January 1, 2011. In addition, there will be no additional co-payments if a polyp is discovered and has to be removed during the screening exam. Medicare will also pay for an annual check-up.
If you are on Medicaid preventive services will be provided at no cost.

OTHER IMPACTS ON COLORECTAL CANCER PREVENTION:

While not specifically addressing colorectal cancer, wellness and prevention of illness are addressed in several new initiatives established and funded by the law including:

Establishment of a National Prevention, Health Promotion and Public Health Council to coordinate prevention, wellness, and public health strategies.
Establishment of a Prevention and Public Health Fund to expand and sustain funding for prevention and public health programs, as well as task forces on Preventive Services and Community Preventive Services to develop, update, and disseminate evidenced-based recommendations on the use of clinical and community prevention services.
Grants to support evidence-based community prevention and wellness programs that strengthen prevention activities, reduce chronic disease rates and address health disparities, especially in rural and frontier areas. Funding for five years beginning in FY 2010.

If you have questions about how the new law will affect you, the New York Times has an interactive site where you can look at your personal impact whether you are insured or uninsured and whether your current insurance is on your own, through an employer, or via Medicare or Medicaid.

This news article was originally posted on March 23rd, 2010 and was accurate at the time of publication. Since then, information may have changed or links may now be outdated. Please call our Answer Line 1-877-427-2111 for the latest information, or talk to your doctor before making any medical decisions.

Posted by Kate Murphy on March 23rd, 2010
Tags: colorectal cancer, colorectal cancer prevention, Health Care Reform

Comments

Julia Taylor

March 26, 2010 at 11:30am

Thanks for providing a simple and easily understood summary of several of the key provisions of the healthcare reform bill. I have a particular interest in colorectal screening and this is the first time I have been able to understand how the bill will effect me as an individual.

Thank you.

Colorectal Cancer Coalition