KHN Morning Briefing

Summaries of health policy coverage from major news organizations

States, Insurers, Employers Move Forward With Health Law Implementation

News outlets report on efforts to implement the new health law, including high risk pools and insurers' summaries of their plans.

High risk pools, which began accepting applications over the summer, are now "are up and running in every state," and "[s]o far, the response has been modest and reviews are mixed," Kaiser Health News reports. "For some, the new preexisting-condition insurance plans -- PCIPs, also known as high-risk pools -- have offered a lifeline that has enabled them to afford crucial treatment that they otherwise would have skipped or had to pay for themselves. Others, however, have been frustrated by strict eligibility rules that have shut them out of the plans, and still others find the coverage too expensive. ... The pools are intended to act as a stopgap until the state-based health insurance exchanges created under the health-care overhaul are up and running in 2014"  (Andrews, 10/26).

Meanwhile, "[a] requirement that insurers summarize their health plans in a short brochure has led to a drawn-out clash between industry and consumer advocates over how to best define health insurance benefits," Politico reports. "The little-noticed provision in the health reform law calls for insurers to outline their health insurance plans on a standardized, four-page form with information about costs, benefits and definitions of commonly used terms [by 2013]. ... 'These documents, if the federal government adopts them, will eventually be like the food labels that we see, with standard terms that consumers can understand when making decisions about what to purchase,' says Maine Insurance Superintendent Mila Kofman, who has co-chaired a working group on the issue, run through the National Association of Insurance Commissioners" (Kliff, 10/26). 

Inside Higher Ed: "One of the early decisions for employers, including colleges, is whether or how to retain 'grandfathered' status for a plan. Employers with plans that were in effect as of March 23, the enactment date of the new law, can maintain their grandfathered status – and thereby be exempt from some of the new law's requirements -- so long as they don't make major changes, such as reducing benefits or increasing employees' out-of-pocket expenses beyond a specified threshold. Losing grandfathered status will trigger a host of new requirements. ... Looming in the distance, for instance, is the year 2014, when a number of health insurance exchanges will begin to offer a choice of health plans to individuals, many of whom will qualify for federal subsidies" (Stripling, 10/26).

The Chicago Tribune reports on employers and the law's requirement to eliminate co-pays for preventive services. "Americans are noticing this and other changes to their health plans as they go through open enrollment, the annual fall ritual that allows workers with coverage to change their benefits. While the Affordable Care Act mandates that many common preventive services be offered at no cost to workers, the challenge lies in getting them to take advantage of this benefit. ... The health law aims to encourage employees to get routine preventive screenings and checkups that could ultimately help lower health care costs. Treating patients after being diagnosed with an ailment or disease is much more costly than prevention efforts. That's why an increasing number of companies are willing to swallow the added costs of covering preventive services and have been offering many checkups and screenings to their employees at no cost" (Japsen, 10/26).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.