As the former president of the Montana Hospital Association and a member of many Montana task forces on health care, I know just how sick Montana’s health care system was before the Affordable Care Act.
For decades, too many Montana families couldn’t afford health insurance. Too many seniors couldn’t pay for needed prescriptions drugs. And kids born with pre-existing conditions were plain out of luck.
It was a broken system that left Montanans one major illness or injury away from bankruptcy.
The Affordable Care Act is building a stronger health care system that will keep more Montanans healthy and out of debt. And while no health care system is perfect, there’s a lot of misinformation preventing Montanans from learning how the law will benefit you and your family.
Let’s start with the part of the law that ends discrimination for pre-existing conditions. Up to 425,000 non-elderly Montanans have some type of pre-existing condition, including 50,000 children. Thanks to the Affordable Care Act, insurers can no longer deny coverage to children because of a pre-existing condition, like asthma, diabetes or acid reflux.
All of my grandchildren were born with acid reflux conditions. This is due to their genetic composition. Without the Affordable Care Act, these innocent babies would likely be excluded from health insurance coverage. Starting next year, this provision will extend to everyone.
The Affordable Care Act also prevents insurance companies from imposing arbitrary lifetime limits on health benefits. Now, cancer patients and folks suffering from chronic diseases won’t have to forgo lifesaving treatment because they can’t afford to pay out of their own pocket.
The law also supports Montana seniors by closing Medicare’s prescription drug “doughnut hole.” I know too many seniors who fell into this coverage gap. Because of the new law, Montanans with Medicare saved an average of $656 on prescription drugs in 2012.
But aside from improving Montanans’ health and reducing costs, the biggest benefit of the Affordable Care Act for all Montanans will be increasing the number of Montanans with high-quality health insurance plans.
Why is it important to you that more Montanans have health insurance? Because uninsured and underinsured people get sick and hurt, too. And when they do, they go to the hospital, which pays for their care and passes the cost onto folks with health insurance. As a result, hospitals and insurance companies charge patients and clients more. It’s a hidden tax – and one the Affordable Care Act aims to repeal.
There’s no doubt the implementation of the law has been far from perfect. The problems with the website and the confusion over health plans are frustrating. The website must be fixed, and people need straight information about what plans they qualify for and what financial help is available to them.
But for every story highlighting the law’s faults, there are many more success stories. Stories of Montanans qualifying for tax credits to get coverage for the first time in their lives. Stories of folks getting checks in the mail because the law requires insurance companies to spend on better care or issue a refund. And stories of individuals living healthier lives because they got the basic, preventative health care they needed.
When I was president of the Montana Hospital Association, we tried for years to rehabilitate our health care system. Because Congress couldn’t agree on serious reform, states and hospitals fought to cut costs and negotiate new plans with insurance companies.
But our system was beyond rehabilitation. Surgery was needed. And thanks to the ACA, we’re already seeing major improvements in Montanans’ health care.
I’ve discussed health care with many Montanans and know it’s a deeply personal issue. Montanans don’t want someone telling us how to care for our families. But for years, that’s exactly what insurance companies did.
As a result, Americans spend more and get less in return from our health care system than almost every other developed country. That cannot continue. We can’t afford it.
The Affordable Care Act is already improving lives and saving many Montanans money. It’s also putting us on the path to a health care system worthy of our great country. I hope you join me in giving it a chance.
Jim Ahrens lives outside of Craig, is the former president of the Montana Hospital Association and former chairman of the National Veterans Rural Health Advisory Committee.