55 to 64 year-olds win in health reform

Fernando Arriola is 58 years old and uninsured. He's having trouble finding insurance on the individual market, says he doesn't know why, but believes it has something to do with the fact that he and his wife both have high blood pressure and are approaching the age of 60.

NPR chronicles Fernando Arriola's story as part of a nine-story series of Americans and health insurance.

Fernando owns his own contracting business in New Orleans, and says that business has been good. He makes about $50,000 a year, but it's not enough for health insurance. At one point, he and his wife could no longer to afford the policy that they purchased on the individual market. Then, when they tried to reinstate it, they were denied even the most expensive catastrophic plan.

Fernando doesn't want to be given anything. He just wants to be able to afford health care and laments that "there has to be a way."

So how will Fernando be helped under health reform?

A new "Talking about Health Reform" fact sheet by Families USA discusses how health reform will make insurance more available and affordable for 55- to 64-year-olds, in addition to providing them with stability and peace of mind:

• Reform will guarantee that older adults who no longer have coverage through their employer will be able to get high-quality, affordable coverage through a new marketplace called a health insurance "exchange." Through this exchange, older adults will be able to shop and compare different plans, then pick the plan that best suits their needs.

• Health reform will prohibit insurers from charging people with pre-existing conditions more for coverage or denying them coverage entirely. It will also place limits on how much more insurers can charge older people for health coverage (although the degree to which they can vary is still being debated in Congress). These protections will ensure that every older adult has access to comprehensive coverage.

• Legislation pending in the House and the Senate would also provide financial assistance to employer health plans that cover early retirees. This legislation would establish a temporary reinsurance program that would help to cover high-cost claims, bringing the cost of retiree coverage down. These savings would be passed on to early retirees in the form of lower premiums and cost-sharing.

• Reform will guarantee that all Americans will have access to high-quality, affordable coverage through the new health insurance exchange and ensure that older adults will be insured until they reach Medicare age.

55- to 64-year-olds are winners under reform. Health Reform is needed so people like Fernando won't have to worry about being too young for Medicare and too old to purchase insurance on their own.