On Thursday, June 28, 2012. the U.S. Supreme Court delivered its keenly awaited decision on the constitutionality of the Affordable Healthcare Act (ACA), often called “Obamacare.” To the general relief of health-care advocates, the Court upheld all but one provision of the law—a requirement that states expand Medicaid coverage or lose the Medicaid funds they already receive.
What does the ACA decision mean for members of Paralyzed Veterans of America? According to Susan Prokop, associate advocacy director for Paralyzed Veterans’ National Advocacy Program, it will maintain the law’s implementation of a host of reforms that protect people with pre-existing conditions—many of them individuals with disabilities—from being discriminated against in the insurance market.
“Overall, the ACA protects you. Insurers cannot impose lifetime limits,” Prokop says, “and they can’t deny coverage to children with pre-existing conditions either.” Adults will get this coverage beginning in 2014. Insurance companies also won’t be able to charge higher premiums to women or those who are ill, and they’ll also face restrictions on their ability to impose higher costs on older insureds.
“Another big thing,” Prokop notes, “is that ACA closes the ‘doughnut hole’ for prescription drugs in Medicare. Discounts will increase each year until the hole is closed completely in 2020.”
For Paralyzed Veterans of America members who have private coverage or coverage through Medicare in addition to VA benefits, insurance market reforms and improved prescription benefits are likely to be the most significant benefits to grow out of the law. In addition, “if you already have coverage or are enrolled in VA medical care, you don’t have to worry about the so-called individual mandate tax [requiring individuals to have health insurance],” Prokop explains.
However, areas of the ACA still need clarification or tweaking. “For one thing, expanding Medicaid now will require some congressional attention,” Prokop says, “since the Court says the federal government can’t make the states expand it or lose what they have now.” She notes that there are also some anomalies in the law that Paralyzed Veterans has been working to correct, foremost among them the issue of keeping young people on their parents’ insurance up to age 26.
“Unfortunately, children covered under a CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) policy that disabled veterans have for family members were left out of this ACA provision,” Prokop explains. “It’s completely inequitable that a disabled veteran’s child loses coverage at 22; whereas others can stay on their parents’ policies until 26. That needs to be fixed.”
Learn more about Paralyzed Veterans’ advocacy efforts
Lee Fleming is a writer based in Washington, DC, whose articles appear in national publications and on the Web.