Janis Cheney, Bismarck, column: Get facts, not spin, on health care reform

By Janis Cheney

BISMARCK -- For the past several weeks, AARP has been traveling the state talking to our members and other older North Dakotans about what the new health care law means for them and their families.

One thing is clear: Many are uncertain about what's in the law. And as the political squabbling continues, misinformation continues to be spread as fact.

It's true the new law will affect most everyone. This is especially true for older Americans. North Dakota has a significant older population who will benefit from key provisions in the new law. In North Dakota, 12.6 percent of the population is age 65 or older and 20.4 percent is between the ages of 50 and 64.

Here's what is not changing under health reform. The law explicitly prohibits any cuts to seniors' guaranteed Medicare benefits.

Here are some of the things Herald readers should be aware of:

n Readers with adult children who need coverage may keep those children on the reader's employer plan until the young people reach age 26. In North Dakota, this provision could provide insurance to 15,000 18- to 25-year-olds currently without coverage.

n Boomers, pay attention: In North Dakota, 13,000 residents age 50 to 64, most of whom work, lack health insurance, often because they find premiums to be unaffordable. Another 24,000 people in that age group buy coverage in the individual market.

Readers with pre-existing conditions may be eligible for temporary coverage beginning in July. In 2014, insurance companies no longer will be able to deny coverage because of a pre-existing condition.

And starting this year, insurers no longer will be allowed to impose lifetime benefit caps or unreasonable annual limits. Similarly, they'll be prohibited from cutting off coverage when their policy-holders get sick.

n The new law will help seniors who are paying thousands of dollars out of their own pocket for their medications because they've fallen into the Medicare Part D "doughnut hole."

In North Dakota, one-third of Medicare beneficiaries fall into this coverage gap. This year, they are getting a $250 rebate to help them pay for their prescriptions. Next year, they'll get a 50 percent discount on brand-name drugs. This could add up to savings of nearly $2,000 next year for those with high drug spending.

Within 10 years, the coverage gap will be eliminated.

n In a push for prevention and starting in January, the new law will let seniors get annual wellness check-ups free of charge, along with free preventive services such as screenings for cancer and diabetes. Consumers of private health insurance also will be able to get free health screenings.

n Independent living is another goal of health reform. States will get added financial support for home and community-based services. In addition, individuals will be able to take part in a voluntary insurance program designed to help people who develop chronic illness remain in their own homes -- and out of nursing homes.

As we meet with our members, the cost of health care reform is also on their minds. The Congressional Budget Office estimates that the law will reduce the deficit by $143 billion over the next 10 years.

We also need to keep in mind that there was a cost associated with doing nothing. Our system of health care was simply not sustainable going forward. In 2006, insurance premiums claimed 17 percent of median family income. Without health reform, six years from now, it's estimated that insurance premiums would have increased to 45 percent of median family income.

AARP believes that everyone should find out what the new law means for them. That's whether you're in Medicare, have an individual policy, get health benefits from your employer or have been unable to get insurance.

It's understandable that this complex law leaves people with questions. But there is no need for uncertainty. Herald readers can look up accurate information at www.aarp.org/getthefacts and other nonpartisan websites such as the Kaiser Family Foundation and the Annenberg Public Policy Center's factcheck.org.

Now that health care reform has become law, it's time to get the facts.

Cheney is the state director for AARP North Dakota.