Christmas rainbow?
From across the pond:
By Duke Helfand, Los Angeles Times
December 23, 2010
“The insurance companies abruptly halted the sale of individual policies for kids in September 2010 rather than comply with provisions of the nation's new healthcare law that required them to accept all youngsters under age 19 regardless of their medical conditions.
“Insurers said at the time that the healthcare overhaul could saddle them with huge and unexpected costs, particularly if competitors exited the market. Their decisions prompted criticism from health activists and a spokesman for the Obama administration, who accused them of abandoning children and families.”
It looks like legislation may not be enough as if all the insurers club together, what are you suppose to do!!!
More legislation!!!
“But a new California law forced the insurers to change course. Beginning Jan. 1, it will prohibit those that abandon child-only coverage from selling new policies in the broader individual insurance market for five years — slicing into profits in a state filled with throngs of potential customers.”
“On Wednesday, Aetna Inc., Anthem Blue Cross, Cigna Corp., Health Net Inc. and UnitedHealth Group Inc. said they would resume sales of child-only coverage Jan. 1 for an estimated 80,000 children who are not insured through family policies or their parents' employers.”
Looks like Obama 1: Insurers 0
"It's good that the insurers are back in the market, even if they had to be brought back kicking and screaming," said Anthony Wright, executive director of the consumer advocacy group Health Access California. "It will make a big difference for thousands of families."
All the insurers have notified the state Department of Insurance of their intention to resume sales.
“……There is plenty at stake. California's private insurance market — where individuals and small businesses buy coverage — generated $17 billion in revenue last year. The market is only expected to grow as millions of uninsured Californians buy coverage, beginning in 2014, through a new marketplace exchange set up as part of the federal healthcare law.”
“Regulators from the California Department of Insurance have been trying to prod insurers to start selling child-only policies once again since they announced their departure shortly before Sept. 23, when the federal healthcare law would have required them to accept all children with preexisting conditions. On Wednesday, officials sent the companies two pages of "guidance" to help them interpret the new state law.”
Guidance? Really!
Perhaps our new government is the one that needs guidance. The sooner they rein in the insurers the better:
No exclusion of pre-existing conditions and no rescission and definitely no dumping.
And a limit of say no more than double the best rates.
Obama administration’s own timeline
Prohibiting Insurance Companies from Rescinding Coverage. In the past, insurance companies could search for an error, or other technical mistake, on a customer’s application and use this error to deny payment for services when he or she got sick. The new law makes this illegal. After media reports cited incidents of breast cancer patients losing coverage, insurance companies agreed to end this practice immediately. Effective for health plan years beginning on or after September 23, 2010.
Prohibiting Discrimination Due to Pre-Existing Conditions or Gender. The law implements strong reforms that prohibit insurance companies from refusing to sell coverage or renew policies because of an individual’s pre-existing conditions. Also, in the individual and small group market, the law eliminates the ability of insurance companies to charge higher rates due to gender or health status. Effective January 1, 2014.
Paying Physicians Based on Value Not Volume. A new provision will tie physician payments to the quality of care they provide. Physicians will see their payments modified so that those who provide higher value care will receive higher payments than those who provide lower quality care. Effective January 1, 2015.
Related:
Posts
0 comments:
Post a Comment