Editor’s Note: This post is part of a series where readers can meet average Americans already benefiting from the health reform law, the Affordable Care Act.
Paul Horne and his wife from Indianapolis, Indiana, have spent a lot of their time thinking about or making life decisions based on their health care coverage.
A few years ago, Paul went without medical treatment for the better part of a year because he didn’t have enough coverage, or money to pay for it. As a result his condition worsened.
Now Paul is on Medicare and his health has improved, but he has been forced to contend with the prescription drug coverage gap known as the donut hole. Hitting the donut hole has devastating consequences for millions of seniors. In some cases, Americans in the donut hole are forced to choose between paying their mortgage bill, buying groceries or getting the medicine they needed.
But that’s changing thanks to the Affordable Care Act. The Affordable Care Act has already provided a $250 rebate check to more than 3 million seniors like Paul who hit the donut hole. This year, seniors who hit the donut hole will receive a 50 percent discount on their brand name prescription drugs. And by 2020, the donut hole will be closed completely.
If the Affordable Care Act is repealed, the donut hole will remain and seniors will pay more for their prescription drugs. But under the new law, Paul won’t have to struggle to afford the prescription drugs he needs.
Paul’s family is also benefiting from the other provisions in the Affordable Care Act that prohibit insurance companies from limiting the amount of care you can receive even if you need it. Paul’s wife’s policy had a one million dollar lifetime limit on the amount of care she could receive. Paul says the provision in the law that eliminates lifetime limits “kind of freeing, makes you think your health care [plan] actually has something to it.”
Listen to his story:
Stephanie Cutter is Assistant to the President for Special Projects.