Feb 26, 2013
A final rule that implements five key consumer protections from the Affordable Care Act were issued by the U.S. Department of Health and Human Services (HHS).
“Because of the Affordable Care Act, being denied affordable health coverage due to medical conditions will be a thing of the past for every American,” said HHS Secretary Kathleen Sebelius. “Being sick will no longer keep you, your family, or your employees from being able to get affordable health coverage.”
Under these reforms effective January 1, 2014, all individuals and employers have the right to purchase health insurance coverage regardless of health status. In addition, insurers are prevented from charging discriminatory rates to individuals and small employers based on factors such as health status or gender, and young adults have additional affordable coverage options under catastrophic plans.
Today’s final rule implements five key provisions of the Affordable Care Act that are applicable to non-grandfathered health plans:
These protections come at a cost that critics say will initially cause large increases in premiums. Placing millions of uninsured and chronically ill people on insurance will load the system with high claims expense; capping premiums at no more than a 3 to 1 ratio from oldest to youngest beneficiaries will raise the premium levels of all younger insureds; guaranteed renewability is already a common provision for health insurance; single risk pools will quickly become “dead pools” at very high premium levels because insurers can’t underwrite new enrollees and their pool can quickly become unbalanced and poisoned by too many chronically ill; catastrophic plans are also currently a common offering in many states.
Anticipating rate issues the final rule amends certain provisions of the rate review program in preparation for the market changes in 2014 and streamlines data collection for insurers and states. And, HHS has increased the transparency by directing insurance companies in every state to report on all rate increase requests. A new report has found that the law’s transparency provisions have already resulted in a decline in double-digit premium increases filed: from 75 percent in 2010 to, according to preliminary data, 14 percent in 2013.
In addition, today the U.S. Department of Labor announced an interim final rule in the Federal Register that provides protection to employees against retaliation by an employer for reporting alleged violations of Title I of the Act or for receiving a tax credit or cost-sharing reduction as a result of participating in a Health Insurance Exchange, or Marketplace. Additional information is available at www.dol.gov/opa/media/press/osha/osha20130327.htm or www.osha.gov.
For more information on this final please visit: http://cciio.cms.gov/resources/factsheets/marketreforms-2-22-2013.html
For information on the rights and protections guaranteed by the health care law, please visit: http://www.healthcare.gov/law/features/rights/
For the full text of the proposed rule, please visit: http://www.ofr.gov/inspection.aspx
Source: Health and Human Services (HHS), News Release - February 22, 2013