Health care law protects consumers against worst insurance practices
Key health insurance protections for all Americans moves forward
The
U.S. Department of Health and Human Services (HHS) today issued a final
rule that implements five key consumer protections from the Affordable
Care Act, and makes
the health insurance market work better for individuals, families, and
small businesses.
“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, 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:
·
Guaranteed Availability
Nearly all health insurance companies offering coverage to individuals and employers will be required to sell health
insurance policies to all consumers. No one can be denied health insurance because they have or had an illness.
·
Fair Health Insurance Premiums
Health
insurance companies offering coverage to individuals and small
employers will only be allowed to vary premiums
based on age, tobacco use, family size, and geography. Basing premiums
on other factors will be illegal. The factors that are no longer
permitted in 2014 include health status, past insurance claims, gender,
occupation, how long an individual has held a
policy, or size of the small employer.
·
Guaranteed Renewability
Health insurance companies will no longer refuse to renew coverage because an individual or an employee has become
sick. You may renew your coverage at your option.
·
Single Risk Pool
Health
insurance companies will no longer be able to charge higher premiums to
higher cost enrollees by moving them
into separate risk pools. Insurers are required to maintain a single
state-wide risk pool for the individual market and single state-wide
risk pool for the small group market.
·
Catastrophic Plans
Young
adults and people for whom coverage would otherwise be unaffordable
will have access to a catastrophic
plan in the individual market. Catastrophic plans generally will have
lower premiums, protect against high out-of-pocket costs, and cover
recommended preventive services without cost sharing.
In
preparation for the market changes in 2014 and to streamline data
collection for insurers and states, the final rule amends certain
provisions of the rate review program.
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/
For more information on how this final rule helps create a better health insurance market for consumers, please visit:
http://cciio.cms.gov/
For information on the rights and protections guaranteed by the health care law, please visit:
http://www.healthcare.gov/law/
For the full text of the proposed rule, please visit:
http://www.ofr.gov/OFRUpload/
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