Pre Existing Condition Insurance and Healthcare Reform

Our healthcare system is changing...are you ready? The Patient Protection and Affordable Care Act is going to have some profound effects on healthcare and how it is paid for. It is important that you understand what changes are coming, when they are coming, and how they are going to affect you. Insurance companies have always been heavily regulated at the state level. The PPACA has introduced a whole news set of federal regulations. As a result health insurance companies will now be forced, by rule of law, to accept everybody regardless of their health, remove cost sharing arrangements for various routine and preventative services, remove or increase the limits on your insurance policy. Since insurance companies are private organizations and the government is not paying for these additional services, you the consumer will have to pay in the form of premiums. Now, I have heard the politicians say that these changes will not increase your premiums...but all I see is increasing premiums. Here are some of the things that the PPAA healthcare reform laws have brought us.

  • Pre-existing condition insurance plan - www.pcip.gov - all States have to offer some type of pre-existing condition insurance or participate in the federal Pre-Existing Condition Insurance Plan.
  • No pre-existing conditions for children 19 and under.
  • No more annual or lifetime limits - this one is confusing because apparently there are some limits for services...but those services haven't been determined yet. Bottom line is it all depends on what they define as "Essential Benefits".
  • Preventative care with no cost sharing.
  • Medical Loss Ration is now 80% for individual and small group health plans and 85% for large group health plans.
  • Limits will be placed on executive compensation.
  • No more Pre-Existing condition exclusions...but not until 2014.
  • Rate reform is coming...but I don't think you are going to like it. Nothing I read indicates that insurance premiums will be cheaper.
  • Health Insurance Exchanges - This one is still kind of up in the air...no one seems to really know how they are going to do this. a lot of different ideas bouncing around.
  • Mandatory Health Insurance!!!! No explanation needed...you have to buy it.