Tag Archives: Kevin w. lucia

Health care reform: States need to take action, a report suggests

1 Feb

imagesFor those who may have not been keeping up with the new health care reforms that are scheduled to become effective in 2014, they are listed below.

  • Guaranteed Issue: Requires insurers to accept every individual and employer that applies for coverage.
  • Ban on Waiting Periods: Employers cannot impose waiting periods longer than 90 days before an employee can be eligible for coverage.
  • Rating Requirements: Insurers are restricted from using health status, gender, and other such factors in setting premiums.
  • Ban on Preexisting Condition Exclusions: Insurers cannot exclude or limit coverage for people with preexisting health problems.
  • Essential Health Benefits: Requires insurers to cover a comprehensive set of health benefits.
  • Out-of-Pocket Cost Limits: Holds out-of-pocket costs to the level established for high-deductible health plans that qualify for health savings accounts.
  • Actuarial Value: Requires insurers to cover at least 60 percent of total costs under each plan and sell plans that meet new benefit tiers based on average costs covered.

*Information provided by The Commonwealth Fund

Although these reforms may sound ideal in writing, a new report provided by the Commonwealth Fund report states that only 11 states, and the District of Columbia have begun to pass laws or regulations in order to put these reforms into action. The 39 states who have not begun to take action could be limiting the effects of the reforms. Continue reading