How the Health Care Law is Making a Difference for the People of North Carolina
For too long, too many hardworking Americans paid the price for policies that handed free rein to insurance companies and put barriers between patients and their doctors. The Affordable Care Act gives hardworking families in North Carolina the security they deserve. The new health care law forces insurance companies to play by the rules, prohibiting them from dropping your coverage if you get sick, billing you into bankruptcy because of an annual or lifetime limit, or, soon, discriminating against anyone with a pre-existing condition.
All Americans will have the security of knowing that they don’t have to worry about losing coverage if they’re laid off or change jobs. And insurance companies now have to cover your preventive care like mammograms and other cancer screenings. The new law also makes a significant investment in State and community-based efforts that promote public health, prevent disease and protect against public health emergencies.
Health reform is already making a difference for the people of North Carolina by:
Providing new coverage options for young adults
Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their family coverage, and, thanks to this provision, 3.1 million young people have gained coverage nationwide. As of December 2011, 95,000 young adults in North Carolina gained insurance coverage as a result of the health care law. For more details on these numbers, visit here.
Making prescription drugs affordable for seniors
Thanks to the new health care law, 114,012 people with Medicare in North Carolina received a $250 rebate to help cover the cost of their prescription drugs when they hit the donut hole in 2010. Since the law was enacted, North Carolina residents with Medicare have saved a total of $110,001,802 on their prescription drugs. In the first five months of 2012, 20,466 people with Medicare received a 50 percent discount on their covered brand-name prescription drugs when they hit the donut hole. This discount has resulted in an average savings of $636 per person, and a total savings of $13,021,616 in North Carolina. By 2020, the law will close the donut hole.
Covering preventive services with no deductible or co-pay
In 2011, 1,161,976 people with Medicare in North Carolina received free preventive services – such as mammograms and colonoscopies – or a free annual wellness visit with their doctor. And in the first six months of 2012, 637,836 people with Medicare received free preventive services.
Because of the law, 54 million Americans with private health insurance gained preventive service coverage with no cost-sharing, including 1,564,000 in North Carolina. But for women especially, it’s a new day. Beginning August 1, women in North Carolina can now get coverage— without cost-sharing—of even more preventive services they need. Approximately 47 million women will now have guaranteed access to additional preventive services without cost-sharing for policies renewing on or after August 1, 2012, including 1,352,427 in North Carolina.
Providing better value for your premium dollar through the 80/20 Rule
Under the new health care law, insurance companies must provide consumers greater value by spending generally at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing. If they don’t, they must provide consumers a rebate or reduce premiums. This means that 216,649 North Carolina residents with private insurance coverage will benefit from $18,678,898 in rebates from insurance companies this summer. These rebates will average $158 for the 118,000 families in North Carolina covered by a policy.
Scrutinizing unreasonable premium increases
In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. North Carolina has received $4.6 million under the new law to help fight unreasonable premium increases.
Removing lifetime limits on health benefits
The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. Already, 3,091,000 residents, including 1,186,000 women and 804,000 children, are free from worrying about lifetime limits on coverage. The law also restricts the use of annual limits and bans them completely in 2014.
Creating new coverage options for individuals with pre-existing conditions
As of April 2012, 3,907 previously uninsured residents of North Carolina who were locked out of the coverage system because of a pre-existing condition are now insured through a new Pre-Existing Condition Insurance Plan that was created under the new health reform law. To learn more about the plan available in North Carolina, check here.
Supporting North Carolina’s work on Affordable Insurance Exchanges
North Carolina has received $13.3 million in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges.
- $1 million in Planning Grants: This grant provides North Carolina the resources needed to conduct the research and planning necessary to build a better health insurance marketplace and determine how its exchange will be operated and governed. Learn how the funds are being used in North Carolina here.
- $12.3 million in Exchange Establishment Grants: These grants are helping States continue their work to implement key provisions of the Affordable Care Act. Learn how the funds are being used in North Carolina here.
Preventing illness and promoting health
Since 2010, North Carolina has received $39 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. This new fund was created to support effective policies in North Carolina, its communities, and nationwide so that all Americans can lead longer, more productive lives.
Increasing support for community health centers
The Affordable Care Act increases the funding available to community health centers in all 50 states, including the 177 existing community health centers in North Carolina. Health centers in North Carolina have received $70.7 million to create new health center sites in medically underserved areas, enable health centers to increase the number of patients served, expand preventive and primary health care services, and/or support major construction and renovation projects.
Strengthening partnerships with North Carolina
The law gives states support for their work to build the health care workforce, crack down on fraud, and support public health. Examples of Affordable Care Act grants to North Carolina not outlined above include:
- $1.3 million for the Personal and Home Care Aide State Training Program, which will help train key health care aides and strengthen the direct care worker workforce.
- $2.5 million for the expansion of the Physician Assistant Training Program (PDF - 66 KB), a five-year initiative to increase the number of physician assistants in the primary care workforce.
- $2.3 million to help North Carolina reduce health care fraud by identifying efficient and effective procedures for long-term care facilities to conduct background checks on prospective employees, thereby protecting its residents.
- $3.5 million for school-based health centers, to help clinics expand and provide more health care services such as screenings to students.
- $1 million to support outreach to eligible Medicare beneficiaries about their benefits.
- $523,000 to support Aging and Disability Resource Centers (ADRCs). ADRCs help seniors, people with disabilities, and their families understand and evaluate their long-term care options, including those available in their community.
- $191,000 for Family-to-Family Health Information Centers, organizations run by and for families with children with special health care needs.
- $5.7 million for Maternal, Infant, and Early Childhood Home Visiting Programs. These programs bring health professionals to meet with at-risk families in their homes and connect families to the kinds of help that can make a real difference in a child’s health, development, and ability to learn -- such as health care, early education, parenting skills, child abuse prevention, and nutrition.
- $3.5 million from the Pregnancy Assistance Fund to provide pregnant and parenting teens and women with a seamless network of supportive services to help them complete high school or postsecondary degrees and gain access to health care, child care, family housing, and other critical support.
Last updated: July 31, 2012