Ninety days after signing the Patient Affordable Health Care Act into law, the Obama administration issued regulations to implement the Patient Bill of Rights, which includes provisions that begin on September 23 for most plans:
- Insurers will no longer be allowed to turn down children because of pre-existing conditions.
- A ban on lifetime limits, as well as a phasing out of annual limits.
- End of rescinding policies of people when they are sick.
- Guarantee of choice of primary care doctors and pediatricians from a plan’s network and no need for referrals for OB-Gyns or emergency care out-of-network.
- Adults under age 26 will be allowed to stay on a parent’s policy. (Some insurers have already made this change.)
Beginning on July 1:
- People who have been unable to secure medical insurance due to a pre-existing condition will have access to the Pre-existing Condition Insurance Plan (PCIP). This is a temporary program, ending in 2014, when insurers will no longer be able to refuse coverage to adults with pre-existing conditions.
Beginning in January:
- Insurers must spend at least 80 percent of premium dollars directly on medical care, and 85 percent for larger groups, with the difference to be refunded to the consumer. (This has resulted in insurers attempting to change the way they label expenses.)
- Insurers will be required to publicly disclose their rates on a new national consumer website.
A statement from the American Cancer Society Cancer Action Network today reads, in part:
“These regulations will help to expand patients’ access to health care and ensure that insurance companies cannot cut patients off from care because of arbitrary annual and lifetime benefit limits, unfairly drop them from coverage through rescission or deny children coverage because of a pre-existing condition.”
“By eliminating arbitrary annual and lifetime benefit limits and strongly enforcing other patient protections, the Affordable Care Act will help patients feel more secure in knowing that they will be able to get the care they need, when they need it.”
Many of the legislation’s provisions will not take full effect until 2014. Meanwhile, a Kaiser Family Foundation survey revealed that consumers in the individual market were hit with a 20 percent increase this year on average.
Many individually insured people already had, or are switching to high deductible plans, with one in four reporting an annual deductible of $5,000 or more. (Count me in that number.)
In an effort to help people in the individual market, states will have more power to review and prevent unreasonable rate hikes.
Just how many people in the individual market will lose their coverage due to cost over the next few years remains to be seen.
Immediate relief will be felt for those who have financial means, but have been refused by insurers. For others who do not get health insurance through their employer, things will very likely get worse before they get better. It’s a start.
Related Reading on Care2:
- Desperate Woman Shoots Herself for Health Care (with video)
- What’s new in health care reform? Seniors, your check is in the mail
- You Didn’t Think the Health Care Crisis Was Over, Did You?
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