The new health care law now prohibits lifetime caps. The result is that health insurance coverage will be extended to the 20,400 people that the government estimates may exceed their limits each year. The law also begins to restrict annual limits on benefits, eliminating them fully in 2014.
The New York Times shares one example of a family who will benefit from this change.
As a healthy couple in their mid-20s, Bill and Victoria Strong’s last concern when shopping for health insurance was a cap on lifetime benefits. Then Gwendolyn was born, and six months later was found to have spinal muscular atrophy Type I, a degenerative condition that typically kills its victims before age 2.
Suddenly, it became vital that their family policy, with Health Net of California, had a generous $5 million limit on benefits. With the help of hugely expensive care at their home in Santa Barbara, Calif. — ventilators, nebulizers, feeding tubes, suction machines — Gwendolyn has defied the odds to survive to nearly 3. And she has already consumed $2 million in care, about half of it from three hospitalizations in her first eight months.
“Anxiety was high,” said Mr. Strong, now 34, “because we were marching pretty quickly toward that $5 million cap. It was always in the back of my mind.”
Now they don’t have to worry about the lifetime cap.
This can happen to anybody. The idea behind health reform is that we should take some of the randomness out of the system. Any of us can experience this type of misfortune, so why not spread the risk?
