Health law's medical-loss ratio and birth control coverage requirements kick in today

Published on August 2, 2012 at 6:42 AM · No Comments

Aug. 1 marks the deadline for insurers to refund consumers and employers if they didn't spend at least 80 percent of premiums on health care. Another provision takes effect requiring most employers to include contraceptive and other women's health services without copays in the insurance plans they offer workers.

The Wall Street Journal: Employers Move To Adapt To Health Law
Two major provisions of the health-overhaul law take effect Wednesday, testing employers' ability to adapt to changes the measure mandates. The law requires employers to distribute millions of dollars in insurance-company refunds to workers whose plans spent a high percentage of their premium dollars on administrative expenses instead of medical care. Employers also will have to begin including contraception and other women's services in workers' insurance plans without charging employees co-payments or other fees (Radnofsky, 7/31).

USA Today: Health Insurance Rebates May Keep Premiums Down For Everyone
As the last of $1 billion worth of this year's health insurance rebate checks goes out to consumers this week, insurers and government officials say the new regulation may be keeping premiums lower for everyone (Kennedy, 7/31).

MinnPost:  Franken's Health Care Reform Rebate Provision Kicks In On Wednesday
An Affordable Care Act provision crafted by Minnesota Sen. Al Franken comes to fruition Wednesday, the deadline for insurance companies to send rebate checks to policy holders if they spent too much money on administrative costs. Franken inserted a provision called "Medical Loss Ratio" into the health care law, requiring insurers to provide rebates to policy holders if they spend more than 15-20 percent of the premiums they collect on administrative items. The first round of rebates are due out to consumers or their employers by Wednesday (Henry, 7/31).

Los Angeles Times: Health Insurers Owe Nearly $74 Million In Rebates To Californians
Nearly 2 million Californians will receive $73.9 million in rebates from health insurers as part of the federal healthcare law, according to state officials. Insurers notified government regulators in June of how much they owed customers in rebates or premium credits because they didn't spend at least 80% or more of 2011 premiums on medical care. The minimum threshold is 85% for employers with more than 51 workers (Terhune, 8/1).

California Healthline: Insurers Must Pay Rebates, Cover Women's Services
Nearly two million California consumers and small business owners will get money back on their health insurance premiums this month because of new federal and state statutes requiring insurers to use at least 80% of their premium dollars for patient care. Another Affordable Care Act requirement goes into effect today ensuring women receive eight types of preventive and diagnostic care in their health coverage, including breastfeeding support services (Gorn. 8/1).

NPR: Under Health Law, 'No-Cost' Birth Control Starts Today
Beginning today, most new and renewing health insurance plans must begin offering a broad array of women's preventive health services, most notably coverage of birth control, at no upfront cost (Rovner, 8/1).

San Francisco Chronicle: No Co-Pay On Some Women's Health Services
As part of the federal health care legislation, insurers will now have to cover eight kinds of women's services - everything from contraception to domestic violence counseling - without charging co-payments, deductibles or any other cost to the patient. But don't put the wallet away yet. Because the change applies only to plans issued on or after Wednesday, most women will not immediately be able to go to their local drugstore to pick up their birth control or go to a doctor for a checkup without having to pay. They'll have to wait until their policy renews, which for many with employer-backed plans is Jan. 1, 2013 (Colliver, 7/31).

CNN: Some Women Get New Benefits Under Obamacare
Beginning Wednesday, all new health insurance plans will be required to provide eight preventive health benefits to women for free. The benefits include contraceptives, breast-feeding supplies and screenings for gestational diabetes, sexually transmitted infections and domestic violence, as well as routine check-ups for breast and pelvic exams, Pap tests and prenatal care. The services are a requirement of the health care reform law Congress passed in 2010. A new report released Monday by the Department of Health and Human Services estimates 47 million women are in health plans that must offer the new benefits (Bonifield, 7/31).

Politico: Dems Broaden Health Care Debate
The Obama administration's requirement that nearly all insurance plans provide contraceptives without a co-pay begins Wednesday, giving Democrats a new talking point about the benefits of the law and Republicans a new hook to repeal the whole thing. On Capitol Hill Tuesday, Democrats talked up the law's benefits for women's health with a bigger sales blitz than they've used for the health care law in a long time -; including floor speeches by top Senate Democrats and a news conference with Health and Human Services Secretary Kathleen Sebelius. She'll continue the sales pitch Wednesday with a Web chat about the law's new coverage rules (Haberkorn and Smith, 7/31).

Medpage Today: Birth Control Rule To Kick In Despite Dispute
A hotly contested provision of the Affordable Care Act (ACA) that requires employers and insurers to offer free contraceptive coverage takes effect Wednesday despite ongoing legal challenges. Starting Wednesday, all new insurance policies must cover birth control and certain other preventive health services with no copay, coinsurance, or deductible. The move has riled political conservatives who say it encroaches on their religious freedom by forcing some faith-based employers to provide contraceptive coverage against their will. While efforts to repeal the change in Congress seem to have cooled, some legal challenges are still under way to the law, which has already been delayed for certain faith-based organizations by the Obama administration (Pittman, 7/31).

In related news -

Denver Post: Denver Firm Allowed To Not Cover Birth Control, Case May Affect Others
A Denver manufacturing company owned by a devout Catholic family got a temporary reprieve from provisions of the Affordable Health Care Act they argued infringed on their religious liberties -; just as the mandate is set to take effect. … U.S. District Court Judge John Kane wrote in his order for preliminary injunction that Hercules Industries, which makes heating and air conditioning equipment, has "adequately established that they will suffer imminent irreparable harm" (O'Connor, 7/31).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.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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