September 23 – Big Changes in the Health Insurance Industry

September 23 was crucial because that’s when the biggest changes (so far) took effect in the Patient Protection and Affordable Care Act (PPACA).

Here’s a summary from the government’s website on healthcare reform.

After September 23, 2010 on any new group insurance plans, insurer’s can’t:
* Deny coverage to kids with pre-existing conditions
* Put lifetime limits on benefits
* Cancel your policy without proving fraud
* Deny your claim without a chance for appeal

And consumers can:
* Receive cost-free preventive services
* Keep young adults on a parent’s plan until age 26
* Choose a primary care doctor, ob/gyn and pediatrician
* Use the nearest emergency room without penalty

These changes take place for any policy issued or renewed after September 23 for group insurance.

So that is the good news, but here are the bad news:

In the individual insurance world in CA only few carriers are implementing the health care reform on September 23. Only Aetna and Anthem have updated their plans to comply with the reform. Kaiser Permanente, Blue Shield and Healthnet will implement the reform at a later time, most likely by January 2011. Unfortunately Anthem rates have not been approved yet by the insurance commissioner, so that their currently only few Anthem individual plans available.

Increased coverage could lead to increased premiums. According to this report by the Kaiser Family Foundation, average health insurance premiums have increased 114 percent just since 2000 – healthcare reform isn’t going to immediately reverse that trend. One new report claims that American families are paying 14 percent more for their health insurance coverage this year than last year – an average increase of $482. Most of that jump isn’t because of higher insurance rates – it’s because employers are paying less of the cost. And that’s another trend that will probably continue – yet another study says that next year, 63 percent of employers will hike the percentage their employees contribute and 46 percent will increase employee out-of-pocket costs.
Some health insurance providers would rather drop than switch. Anthem, Aetna, Cigna have announced they won’t offer any more health insurance policies solely covering children, because of the pre-existing condition provisions of the new law.

The “full force” of healthcare reform doesn’t happen until 2014. This is just the appetizer – and very likely a catalyst for increased debate over health care and our government’s role in it. Stay tuned.
In the meantime, if you’re looking for health insurance right now contact info@solidhealthinsurance,com