The Affordable Care Act and You! 5 Facts Moms Need to Know

The Affordable Care Act and You! 5 Facts Moms Need to Know

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Making sure your baby is healthy isn’t a choice, it’s a right!

The dust has settled on the Affordable Healthcare Act for 2014. Or has it? Did you know that Open Enrollment for 2015 starts in less than 5 months?  (The site goes live on November 15, 2014 and is open until February 15, 2015.) A lot of people are still confused about the Affordable Care Act (ACA), what is and how it affects their families.  And who can blame them?  Even those of us who work in this field find ourselves scrambling for the “right” answers.

There are a few facts that haven’t changed since the ACA’s start.  Here are just 5 key points that ALL moms need to know when it comes to navigating through the Affordable Healthcare Act:

1.     Insurance companies are MANDATED to cover ALL children through age 19! Young adults (between ages of 19 and 26) are now allowed to stay on their parents health plan unless their employers offer health insurance.

2.   No PRE-Existing Conditions carve-outs: That means that neither you nor your children can be denied insurance coverage due to a pre-existing condition like asthma and diabetes, a practice that once left about 17.6 million kids uninsured. Even better?  Insurance companies cannot charge higher rates for members with pre-existing conditions.

3.   Pregnancy and pre-natal care is a covered benefit.  For those of us who had our children in the early 2000’s it’s a relief to know that pregnancy is no longer considered a “pre-existing condition” for which we could be denied coverage.  Women-specific tests that are now covered under the ACA include:

  • Well-woman visits
  • Gestational diabetes screening that helps protect pregnant women from one of the most serious pregnancy-related diseases.
  • Domestic and interpersonal violence screening and counseling.
  • FDA-approved contraceptive methods, and contraceptive education and counseling.
  • HPV DNA testing, for women 30 or older.
  • Sexually transmitted infections counseling for sexually active women.
  • HIV screening and counseling for sexually active women.
  • Mammograms and Colonoscopies (since Sept 2010)

Further, and this is one that is near and dear to my heart, um, breast: Breast pumps are also a covered benefit under the ACA. In fact, Breastfeeding support, supplies, and counseling are all covered benefits.

4.   “You don’t eat in the bathroom, why should my child?”  How many times have you wanted to say that to someone who glared at you while you were nursing your baby?  Employers MUST offer a non-bathroom private space for breastfeeding moms to pump during the work day (for at least a year after childbirth

5.  Preventative Care including Immunizations for your children are a covered benefit.  All newborn care is considered a “preventive service” under the ACA. Providers have to give immunizations and other preventive health services for infants, children, and adolescents without any cost sharing.

6.   Not Everything Has Gotten Easier:  While critics may cite the many problems with the ACA, many folks are benefitting from this legislation.  However, one of the biggest downsides that I discovered has to do with changes to Flexible Spending Accounts. In past years it was easy to submit receipts for over-the-counter medication (OTC) like cold medicine or eye drops to one’s Medical Flexible Spending Account and be reimbursed for the cost.  Not anymore.  Now you have to get a prescription from a physician if you want to receive reimbursement. Finally, the largest allowable amount of money that may be included  in your Medical Savings Account was decreased  to $2500.

Want more information about the Affordable Care Act and how it affects you and your family, please visit the government website at www.healthcare.gov

Life Lessons: “It’s Not Fair”

Life Lessons: “It’s Not Fair”

My daughter came home late from her weekly dinner with her grandmother. At nine, she hasn’t succumb to pre-adolescence moodiness and was amicably sharing the details of her day as she pulled out her homework assignments for her grandmother to check.  (On Thursday nights, Grandma checks the homework as this is considered “Mom’s night off.”)  She told us that during class today, her teacher asked the students a question and then called on one child (not Lulu) to answer it.  When the child responded to the inquiry correctly, Lulu’s teacher gave her a “class dollar.”

(Class dollars are rewards for doing something well or for going out of your way to help a fellow classmate.  The students save up these “dollars” and can buy things like having lunch with their teacher or “buying” a homework pass for specified amounts of “class dollars.”  I guess you could call it positive reinforcement/free trade?)

Lulu later approached the teacher later and commented that had the teacher called on her (Lulu), she would have given the same answer.  Lulu told her teacher that she didn’t think “it was fair” that the other student received the dollar when she also knew the answer.  The teacher’s response? “Life’s not fair.  Get used to it, Honey.”

Err..what did she say?  I asked Lulu to repeat it so I could get the words right: “Life’s not fair.  Get used to it, Honey.”  Pretty rude and abrupt if you ask me.  And now I am facing a dilemma starting with how the teacher’s response impacts my daughter?  All school year, Adam and I have tried to teach Lulu some basic concepts about common courtesy based on the following:

THINK!

THINK!

What does it say about Lulu’s teacher, and adults in general, when an adult and someone our daughter looks up to does the complete opposite of what we have been so diligently teaching her? (The above sign is prominently posted on our back door as a constant reminder to ALL of us to do and say the right things.)   I wonder how the teacher would have felt if Lulu had said “Life’s not fair.  Get used to it, Honey” to her?  Probably pretty annoyed.  It seems unfair to expect a 9-year-old to respond to an adult’s censuring comments with a mere shrug of the shoulders and a smile.  What was the teacher expecting would be the outcome from her harsh words to my daughter: Lulu would learn a valuable life lesson?  Or maybe my daughter should simply repeat her teacher’s words when confronted by a friend about the unfairness of a situation.  After all, she’ll reason, the teacher said those words to her, right?

I know that everyone is entitled to a bad day or two.  And maybe Lulu whined when she complained about the lack of fairness but I guess I hold teachers to a higher standard than I hold others.  What Lulu’s teacher said to her was hurtful and mean.  Calling her “Honey” almost makes it worse than if she hadn’t used that word.  In our house, if someone, adults and children included, says something hurtful to another member of the family, he or she is expected to apologize.  I can explain to Lulu that what the teacher said was wrong but I am not sure how to rationalize to my daughter why her teacher may not apologize for being a “git.”

So, what do you think?  Should I overlook this interaction and help Lulu to focus on what’s important: learning about minerals and parallel circuits?  Or do I send the teacher a note requesting that we speak so I can discuss what I feel is an unacceptable interaction with my child? I’m not sure that there is a right answer.  I guess I’ll have to file it away in the growing folder entitled “Things I Wish Hadn’t Happened to My Child but Should Be Considered Life Lessons.”