Insurance reform empowers individuals, families

As Congress nears an historic vote to reform our health insurance system, there are many reasons for American families to root for them to succeed. The legislation will slow rising premium costs, so that employers can continue to offer health benefits and wage increases. Dozens of innovative pilot projects will be funded to give doctors and hospitals incentives to provide better care. It will reduce the burden of debt we’re passing on to our children, cutting the deficit by $100 billion over the next 10 years. But perhaps the biggest benefit for everyday Americans is that they and their doctors will have more control over their healthcare decisions.


As Congress nears an historic vote to reform our health insurance system, there are many reasons for American families to root for them to succeed. The legislation will slow rising premium costs, so that employers can continue to offer health benefits and wage increases. Dozens of innovative pilot projects will be funded to give doctors and hospitals incentives to provide better care. It will reduce the burden of debt we’re passing on to our children, cutting the deficit by $100 billion over the next 10 years. But perhaps the biggest benefit for everyday Americans is that they and their doctors will have more control over their healthcare decisions.

Health insurance markets today are failing American families. Insurance companies have all the power. In today’s market, too many insurance companies can collect premiums for years, only to cancel your coverage when you get sick. All they need to do is find a mistake on your paperwork from years ago. If you’re one of millions of Americans with a pre-existing condition like high blood pressure or diabetes or arthritis, or if you once had breast cancer, insurance companies can refuse you coverage. Or they might sell you policy with a cap on your benefits, so that your insurance disappears when you need it most.

Some say that Americans could shop around for a better deal. But families usually don’t have a lot of options. In 39 states, one or two insurance companies control at least half the market. These plans are often so full of fine print that it’s hard to tell how much security they provide. And if you have the time to read all that fine print, you may find out that the answer is: not much. Some of these plans don’t even cover basic preventive care, leading to stories like the one I read recently about a mother who had to put off getting a her own check-up and mammogram until her son broke his arm and used up their family’s entire deductible.

Our health insurance system makes many Americans feel powerless. People who have insurance are afraid to lose it. So they stay at jobs they don’t like and put off their plans to start their own business. Or they pay hundreds of dollars a month for a policy they know offers only threadbare protection. When we’re healthy, many of us take our health insurance for granted. But in the back of our minds, we know we’re just a pink slip or a bad test result away from being a victim in a health insurance market that doesn’t meet our needs.

Health insurance reform is going to give American families better choices. Reform will create some simple and long-overdue rules for insurance companies: no denying coverage based on a preexisting condition, no annual or lifetime caps on benefits, and if you paid for your policy, it can’t be taken away. And because it saves money and saves lives, insurance companies won’t be allowed to charge for preventive care like checkups and screenings that keep people healthy and out of emergency rooms.

Reform will make getting health insurance easier than ever by creating a new consumer-friendly marketplace called an exchange. Instead of hunting through the yellow pages for plans and then scouring their fine print, consumers will be able to make decisions easily, compare benefits and prices, and have affordable choices

Perhaps most importantly, a lot of the old worries about insurance rules will go away. You won’t have to worry about your application getting rejected because your child has asthma. That will be illegal. You won’t have to read through hundreds of pages to figure out whether checkups are covered. They will be. And you won’t need an expert to choose the plan that is right for you. The key details will be easy to read and easy to compare.

For too long, Americans have been at the mercy of insurance companies in markets that are unfair, uncompetitive, unaffordable, and closed off to millions of people. By passing health insurance reform, Congress will empower families to get the health insurance they need. Then insurance companies will have to work to earn your business. It’s about time.

Sebelius is secretary of the Department of Health and Human Services.