Rules For Free Preventive Services Requirement Announced
During a Wednesday news conference, the Obama administration unveiled regulations for implementing provisions of the new health that will require insurers to fully pay for some preventive services.
The Associated Press: "From counseling for kids who struggle with their weight, to cancer screenings for their parents, preventive health care will soon be available at no out-of-pocket cost under consumer rules the Obama administration unveiled Wednesday. That means no copays, deductibles or coinsurance for people whose health insurance plans are covered by the new requirements. The Obama administration estimates that 41 million Americans will benefit initially, with the number projected to rise to 88 million by 2013. Many large company plans, which usually offer solid preventive benefits, will be exempt from the requirements for the time being" (Alonso-Zaldivar, 7/14).
Reuters: "'Unfortunately, too many Americans don't get the preventive care they need to stay healthy and keep health care costs down for all of us,' said Kathleen Sebelius, the secretary of health and human services. The rules will go into effect in September, six months after Congress passed the health care overhaul" (Lentz, 7/14).
The Washington Post: First Lady Michelle Obama, in announcing the new regulations, said, "Getting access to early care and screenings will go a long way in preventing chronic illnesses like diabetes, heart disease, and high-blood pressure." Obama, Sebelius and Jill Biden, wife of Vice President Joseph Biden, made the announcement at George Washington University Hospital.
"And good preventative care will also help tackle an issue that is particularly important to me as First Lady and as a mother - and that is the epidemic of childhood obesity in America today. These are important tools, and now it's up to us to use them," Obama said (Henderson, 7/14).
The Wall Street Journal: "Cancer screenings, including mammograms and colonoscopies, as well as obesity prevention services, immunizations, blood pressure screenings and tobacco cessation services are among those that will be available to consumers without a copayment or other direct costs for consumers on new health plans after Sept. 23." The Journal later updated the story to says that "birth control will not qualify as preventive." However, Planned Parenthood is advocating to get it covered (Adamy, 7/14).
In other health reform policy news, Maine has asked the federal government to exempt it temporarily from adhering to health reform law rules governing medical-loss ratios, saying it could force one of the state's health plans out of business in the state, according to The Wall Street Journal, in a separate story. "At issue are tougher rules governing the so-called medical-loss ratio, a measure of how much insurers spend on medical care compared with their administrative expenses and profits. Under the new law, insurers must pay out at least 80% of the premiums collected from individuals on medical care. Regulators at the National Association of Insurance Commissioners are drafting rules to determine what insurers can count as medical expenses and what protections might help smaller plans stay afloat."
Maine's insurance superintendent said the rule, if implemented too quickly, could force HealthMarkets Inc. to stop doing business in the state, leaving just WellPoint's Anthem Blue Cross & Blue Shield the sole option for consumers. "The law allows HHS to grant exemptions if the requirement will upend markets. HHS has received the letter, which is the first from a state regulator, and it will be establishing the process for reviewing such requests in regulations that it plans to issue, said an HHS spokeswoman" (Johnson, 7/14).