TJC Commentary - TJC's Jennifer Tlumak Shares Her Thoughts on Healthcare Changes

Our nation’s health insurance and delivery system is changing, and TJC is keeping pace, ensuring our clients have access to current information on locating, obtaining, and keeping meaningful health care coverage for their families. The Affordable Care Act, or “health reform” as it’s popularly known, is the law of the land. The law has lots of benefits for our clients, and although key provisions have yet to go into effect, we’re already seeing the real world impact of this historic legislation.

A breast cancer survivor who’s losing TennCare may be able to get immediate coverage, without being screened for pre-existing conditions, in the federal high risk pool that began on July 1, 2010. An elderly uninsured woman with extensive prescription drug needs may also benefit. This new high risk pool created by Affordable Care Act has some benefits over the state version, AccessTN. For example, the federal program has no waiting period for coverage of major medical conditions, and that’s a huge benefit to some of our clients.

A small child with seizures who relies on his father’s employee insurance plan will not be subject to pre-existing exclusions starting in early 2011, when their plan year begins. Health reform is the reason this child and his family will be protected from high out-of-pocket medical costs for his rare disease. The child will be covered, and the private insurance company will be responsible for covering this sick child – including his pre-existing condition – as well as his healthy siblings.

We still don’t have a perfect solution to our nation’s health care problems. But the changes are encouraging: ending rescissions and discrimination on the basis of pre-existing conditions, extending coverage to very low-income adults, providing subsidies so that more people can afford better insurance, and regulating the insurance companies by mandating that they put patient care ahead of profits. In my daily work with clients, I’m beginning to see the positive impact of some of these changes. I look forward to seeing more benefits as the Affordable Care Act is implemented more fully.