What health care reform means for families with a premature baby

On March 23rd the POTUS signed The Patient Protection and Affordability Act of 2010, often referred to as the health reform law. What does this law mean if you have a premature baby?

It means:

  • As of September 23rd, 2010 your child can no longer be excluded from an insurance plan because of a pre-existing condition.
  • It means the predatory practice of charging impossible prices for children with pre-existing conditions will stop (although I am not too sure how they will police that one).
  • It means you can keep your child on your family insurance plan until he/she is 26.
  • There will be no co-pay for well-child (preventative care visits) and vaccinations.
  • The elimination of lifetime maximums. The average cost of care in the first year of life for a preemie is $50k, but many babies end up with $250,000 or even higher NICU bills. You can eat through a $1 million deductible far quicker than you think.
  • It means you have a better chance of getting a group plan (a far better option rate wise than purchasing an individual policy) as people can band together and form co-ops for buying insurance. The more people in a group looking to buy health insurance the lower the rates.
  • Medicaid and CHIP (government plans) are supposed to have less restrictive financial eligibility requirements.
  • Subsidies will be available for those with more limited incomes to help purchase insurance.

The plan is not perfect, but in a nutshell it means a premature baby is more likely to have health insurance and therefore coverage for PT, OT, speech therapy, eye doctor, various and sundry specialists, ER visits, surgeries…never mind well-baby checks and vaccinations.

Think of the perfect health care situation as a ladder with 100 steps. With the signing of this bill into we are now on the 5th rung. It’s somewhere to start.

Remember, more than 12% of babies in the US are premature so parents of preemies are the second largest minority. That’s a lot of votes.

You shouldn’t have to worry about health insurance when your baby is premature. It is already unfair enough.

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7 Responses to What health care reform means for families with a premature baby

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  3. Michelle says:

    Thank you so much for posting this Dr. Jennifer! I voted for Obama because of his promises for Health Care Reform and I have gotten nothing but criticism. A major portion of that criticism from family members.

    As you know our son Ty was born 3 months early and was on oxygen for almost 2 years. I know we don’t know everything that is involved with The Health Reform law, but we needed change and more importantly hope!

  4. Simon says:

    Thank you so much for posting this Dr. Jennifer! I voted for Obama because of his promises for Health Care Reform and I have gotten nothing but criticism. A major portion of that criticism from family members.

    As you know our son Ty was born 3 months early and was on oxygen for almost 2 years. I know we don’t know everything that is involved with The Health Reform law, but we needed change and more importantly hope!

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  7. Heather says:

    We are financially struggling due to the increases in our health insurance plan (through my husband’s employer). We could get insurance cheaper through an individual plan but the insurance company has labeled our 1 year old daughter as a high risk even though she has not been seeing specialists often or qualified for intervention (due to prematurity). Because we are in middle class (lower to mid section), we probably won’t qualify for the state health care plan for children which would be considerably cheaper than the 500% hike in premium which an individual plan would charge for our daughter. I see no improvements in health care possibilities for premature children. This is particularly discouraging since our daughter is so robust and thriving and meeting milestones ahead of where she should be…will she always be labeled high risk due to premature birth?

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