New law brings changes to health insurance rules this week

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News outlets previewed changes due to this week's 6-month anniversary of the health law.

The Palm Beach Post: "A variety of consumer-friendly health reform rules will go into effect this week, promising to make life easier for young adults, parents, children with pre­existing conditions, people with chronic diseases, and people appealing claims that have been denied. ... Starting Thursday, insurance companies must allow young adults to remain on their parents' plans until age 26, with some conditions. That change will improve insurance access for an estimated 86,300 young people, according to Census Bureau and White House estimates. (Singer, 9/19). 

The St. Louis Post-Dispatch listed several of the new rules: "Insurers can no longer deny coverage for children under age 19 because of pre-existing conditions. Checkups, immunizations and other basic preventive health care will become free for many people with health coverage, although many others will fall through a loophole. If you get seriously sick, the insurance company can't cancel your coverage because you forgot to tell them about the hangnail removed five years ago. Coverage can still be canceled if you deliberately lie about something important on your insurance application, but not for accidental omissions. Lifetime coverage limits disappear, and annual coverage limits start to fade away. There's a stronger appeals process for when insurance companies deny care" (Gallagher, 9/19).

Atlanta Journal-Constitution: "For those on Medicare: Discounts will be provided for beneficiaries in the so-called 'doughnut hole' who must pay for their own prescriptions. No co-payment will be required for preventive care or an annual 'wellness' visit. Over time, extra benefits under Medicare Advantage may vanish because the new law cuts subsidies to insurers who provide the plans" (Steiden, 9/19).

The Wall Street Journal: "Health-care benefits are expected to improve for many workers, but choices are expected to be more complicated and expensive as employers try to comply with the Patient Protection and Affordable Care Act, which will be phased in over a few years. Among the changes to expect: additional coverage for young adults, well care and pre-existing conditions, but also higher premiums, co-pays and out-of-pocket expenses, according to industry surveys. Most employers also plan to increase efforts that encourage workers to participate in health-and-wellness programs" (Mincer, 9/19). 

Clarion-Ledger: "For small business owners, those with 25 or fewer employees, the law provides for tax credits of up to 35 percent of the average cost of a small group plan to offset the costs. More than 90 percent of businesses in Mississippi fall into this category, according to a survey by Families USA and the Small Business Majority. They will have to cover at least 50 percent of each employee's health insurance premium. The credit will be applied to the 2010 tax return" (Ayres, 9/19).

The Kansas City Star: "Unless you have a child with a chronic illness, you probably haven't given much thought to finding affordable health insurance that covers youngsters with pre-existing medical conditions. For parents of the millions of children with long-term health issues, this can be a huge worry. Some relief is on the way with new health care reform provisions scheduled to go into effect next Thursday. One new rule will prohibit insurance companies from excluding coverage for children ages 19 and under who have been diagnosed with pre-existing health conditions, such as Type 1 diabetes, high blood pressure, attention deficit disorder, obesity, or even acne" (Rosen, 9/18). 

Related, earlier KHN stories:

A Consumer's Guide To The Health Law, Six Months In (Carey, 9/15)

Key Health Law Provisions Begin Sept. 23 (Andrews, 9/14)


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Millions were booted from Medicaid. The insurers that run it gained Medicaid revenue anyway.