Healthcare reform will be phased in little by little over the next three years and several months. What has happened so far has not had a lot of impact on Connecticut medical insurance policies or the costs of the policies. However, the mandates that go into effect on September 23, 2010 may change that.
Here are some of the highlights of the changes for 2010.
Additional Funds for Medicaid
On April 1, 2010 additional funds became available to the states to help them cover more low income individuals and families through Medicaid.
Medicare Prescription Drug Costs Relief
In June of 2010 the first checks were mailed to seniors who reached the Medicare Prescription Drug “Donut Hole.” Checks for $250 were mailed to 4 million seniors who had high prescription costs to offset some of their Rx expenses.
Medical Insurance Subsidies for Early Retirees
In June of 2010 the Early Retiree Reinsurance Program started reimbursing participating employer-sponsored plans for part of the cost of those who retire before age 65.
More Options for Those with Pre-Existing Conditions
In July of 2010, Connecticut as well as many other states have developed new programs for those with pre-existing conditions.
Medical Insurance for Young Adults
As of September 23, a child will usually have the options of being insured by a parent’s policy until age 26. This will have no impact on Connecticut as we were well ahead of the curve here. As of January 1, 2009 most young adults under the age of 26 can be covered under a parent’s policy whether or not they are a student.
Preventative Medical Care Mandates
Policies that are effective on or after September 23rd will need to cover preventative care such as mammograms and colonoscopies without any cost shares such as deductibles or co-pays. Many of the policies sold before September 23rd by Anthem BCBS and Connecticare as well as other insurers came close to meeting this mandate. This should not have a huge impact on rates for those policies or for most others.
Insurance Companies Prohibited from Rescinding Coverage
This is another one that shouldn’t have much impact. Reputable companies like Anthem Blue Cross, Connecticare and Aetna have had not rescinded coverage based on minor misrepresentations. The new law still allows insurance companies to rescind coverage where there is “fraud or intentional misrepresentation of material fact.” This is pretty close to the way reputable companies dealt with incorrect information on applications before the mandate.
If you incorrectly enter the date you last had the flu, nothing is likely to happen. If you fail to mention that you are undergoing chemotherapy treatment, you can expect that your policy will be rescinded.
Eliminating Annual and Lifetime Limits on Benefits
This is a good one and one that will have some impact. Although companies will probably still be able to limit coverage for certain benefits like prescriptions, major benefits like those covering hospital stays can no longer be limited. There will be no more lifetime caps and no more annual caps on policies that become effective on or after September 23, 2010.
I’ve always thought that policies that have low lifetime caps or annual caps were not worth selling. We have never featured any of those policies on our website.
Many of the policies sold before September 23rd have had no lifetime limits. Connecticare has had no lifetime limits on any of their policies and Anthem BCBS has had no lifetime limits on their Lumenous policy series for the last several years.
This will have no impact on some policies but a significant impact on others. I’m glad to see those policies go!
Children Cannot Be Denied based on Pre-Existing Conditions
This will have a big impact. This health care reform mandate will hurt Connecticut children. Many insurers have announced that they will no longer accept children who apply without a parent. I don’t know of any company that sells private individual or family policies (non group) in Connecticut that will accept children for standalone policies after September 23rd.
This new law may make insuring children so unprofitable that it will have a major impact and may result in fewer children being eligible for coverage. Anthem Blue Cross has bucked the trend in other states. I’m crossing my fingers and hoping that when they do announce their intentions that they will cover children on standalone policies even if they do so at a dramatically higher price.
For More Information About Healthcare Reform
For more information about the changes that you can expect from healthcare reform, you can view the healthcare reform timeline on healthcare.gov,