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ACA & Women, ACA: Basics

12 Days of “Gifts” from the Affordable Care Act – Gift One: Building a Bridge to Ending Pre-Existing Condition and Gender Discrimination

In the spirit of this holiday season, the Wisconsin Alliance for Women’s Health invites you to share in a series of blog posts, each containing a special “gift” from health care reform. Some have already been implemented and some are gifts still to come; but all are very important improvements to our healthcare system.

Gift One:  Building a Bridge to Ending Pre-Existing Condition and Gender Discrimination

For our first blog in the series, we focus on widely celebrated provisions of the law, which will lead to the end of discriminatory practices in the insurance industry towards those with pre-existing conditions and women.

Phase One: Development of a Pre-Existing Condition Insurance Plan (PCIP) by July 1, 2010

Phase Two: Banning the denial of coverage to kids (under 19) based on pre-existing conditions, effective September 23, 2010 for new and existing group plans

Phase Three: Banning discrimination due to pre-existing conditions or gender for all ages, effective January 1, 2014

As we know, for women and other individuals trying to receive coverage after being branded with the term “pre-existing condition” it is nearly impossible. The same goes for women trying to receive the same coverage as men at the same rate. These common-sense steps to reform are setting up the bridge that leads us to the ultimate gift: the end of discriminatory practices based on gender and pre-existing conditions.

For Wisconsin women, there was already a similar program to PCIP in the state. The program, known as the Health Insurance Risk Sharing Plan (HIRSP), was expanded to cover newly eligible individuals in the HIRSP Federal Plan. This expansion was initiated by a provision in the law that increased eligibility criteria and provided $5 billion dollars in funding that the federal government disbursed among the states to create or expand their programs to meet the new criteria. Read this blog, to see firsthand how the program has helped women in other states.

The next step is the end of denying coverage for kids under the age of 19 due to a pre-existing condition. These pre-existing conditions include disabilities diagnosed before applying to coverage, as well as many other common health issues such as asthma. The provision currently applies to all plans created after September 23, 2010 and all existing group plans.  The rule does not apply to “grandfathered” individual health plans but will extend to ALL individuals in ALL plans regardless of age beginning on January 1, 2014.   

Stay tuned to the Raising Wisconsin Women’s Voices blog for more gifts of the Affordable Care Act over the next 12 days.

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Discussion

4 thoughts on “12 Days of “Gifts” from the Affordable Care Act – Gift One: Building a Bridge to Ending Pre-Existing Condition and Gender Discrimination

  1. This is great! Thanks for doing this series!

    Posted by Lauren Michelle Kinsey | December 15, 2011, 1:34 pm

Trackbacks/Pingbacks

  1. Pingback: 12 Day of “Gifts” from the Affordable Care Act – Gift Two: Expanding Coverage for Young Adults « - December 15, 2011

  2. Pingback: 12 Days of “Gifts” from the Affordable Care Act – Gift Twelve: Expanding the Possibilities « - December 25, 2011

  3. Pingback: 12 Days of “Gifts” from the Affordable Care Act – Gift Three: FREE Preventative Care « - October 23, 2012

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