The American Heart Association/American Stroke Association has long recognized that the current crisis in our health care system threatens our mission of building healthier lives, free of cardiovascular diseases and stroke. With more than 46 million uninsured people in the United States, and many more struggling with the rising costs of health insurance and health care, the need for meaningful health reform is urgent.

The association believes that the new health reform law, the Patient Protection and Affordable Care Act, makes a number of important improvements to the current health care system that we can build on in the years to come. Although it isn't perfect, the health reform law largely aligns with the association's six, patient-centered principles for reform. These principles concentrate on access to care, preventive services, quality health care, the elimination of health disparities, continued biomedical research to improve the prevention and treatment of heart disease and stroke, and an adequate and diverse workforce.

The burden of heart disease, stroke and other cardiovascular diseases can be particularly problematic for those without health insurance or for those with inadequate coverage. The uninsured with CVD experience higher mortality rates and poorer blood pressure control. People who lack health insurance experience up to a 56 percent higher risk of death from stroke than those who are insured. The uninsured and under-insured are also less likely to take needed medications and to forego preventive care. A 2009 survey of CVD patients found that more than half of the patients surveyed had difficulties paying for medical care, even though most had insurance, and 46% of those who had difficulty paying their medical expenses said they had delayed getting needed care. (See more results from this survey below.)

Examples of how heart disease and stroke patients and their families may benefit from health reform include:

• Adults with heart disease, stroke, high blood pressure, or other CVD risk factors who are under 65 years old and don't have health insurance coverage but aren't eligible for Medicare or Medicaid will now have access to affordable health insurance options through the Pre-Existing Condition Insurance Plans beginning immediately for those who have been uninsured for at least six months and through state-based insurance exchanges beginning in 2014;
• Children with congenital heart defects who can't get health insurance coverage because of their pre-existing condition can no longer be denied insurance beginning in 2010;
• Medicare beneficiaries with chronic conditions who must take many medications will benefit through the immediate narrowing and ultimate closure of the Medicare prescription drug coverage gap and through better coverage for preventive care; and
• Families who purchase coverage through an insurance exchange will no longer have to worry about incurring high amounts of medical debt because essential health care services will be required to be covered, annual and lifetime limits on benefits will no longer be allowed, and there will be limits on the amount of out-of-pocket costs families will be required to pay.

Although the Patient Protection and Affordable Care Act is now law, the AHA recognizes that our work to ensure that all residents of the United States have meaningful, affordable health care coverage is not done. We are committed to continuing to work with Congress, the Administration and our partners in the public and private sectors to monitor and implement reform and to further improve upon the health care system.

On this site, you can learn more about why health care reform is important to patients with heart disease and stroke or those at risk for cardiovascular disease and about the AHA's work to make health care more accessible, affordable, and adequate for patients.