“They” say that today, September 23, 2010, is a milestone in health care reform, or as I’ve affectionately been calling it, Stealth Care Reform. Some of the new federal mandates go into effect today, but will affect only some of you:
1. Removal of pre-existing condition exclusions for minors up to age 19. But, the law does NOT state that insurance companies must issue a policy to a child. It only says that IF a policy is approved, all pre-existing conditions must be covered. The insurance companies said early on that they will abide by the intent of the law, which was to provide insurance to any child, regardless of the child’s health condition or history. The unintended consequence: now most of the major players in the country have said they won’t issue “child-only” policies, meaning that at least one adult must be on an application with a child in order for the child to get health insurance.
2. Coverage for dependents up to age 26. If an adult child wants to stay on Mom & Dad’s policy they can. Isn’t it time to grow up?
3. Preventive care with no co-pays and no maximum benefit. All new policies that you buy after today must include this provision.
4. Removal of lifetime dollar limits. This one is going to be a pricey mandate for you. Watch how the insurance companies raise their rates to offset this unlimited financial exposure. The Insurance Mom has said it before and I’ll say it again… mandates are expensive! Must I repeat myself?!
5. Removal of annual coverage limits. Fortunately, in California, our policies have not had annual limits on benefits (except for the state’s High Risk Pool, which has an annual limit of $75,000 in benefits, and is not subject to the new federal mandates).
6. Nondiscrimination rules for group coverage. If you’re a “highly compensated” executive in your employer’s group plan, no more royal treatment for you! All employees must be treated equally when it comes to group benefits (well, mostly, but that’s a whole other kettle of fish).
7. Updated rescission rules. Cancellation of your individual policy by an insurance company is prohibited, except for cases of fraud or intentional misrepresentation. The burden of proof is on the insurance company.
More of the reform laws will go into effect each year, through 2019, with the bulk of them hitting the fan in 2014. Raise your hand if you think this is going to 1) actually happen and 2) be a good thing.
Oy.
