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Details Under Health Plan To Be Hammered Out

Posted by Jane Akre
Monday, May 24, 2010 1:36 PM EST
Category: Protecting Your Family
Tags: Health Care Reform, President Obama, Insurance, Big Insurance, Pre-existing Conditions


IMAGE SOURCE: National Public Radio/ Web site/ images from Wise, Virginia

Devil In The Details

How are Americans affected by the new health care law?

Regulators are trying to figure that out.

Americans were promised by President Obama that they could hold onto their preferred insurer and the new plan will exempt many plans from some of the restrictions under a grandfathered status.

But consumer advocates say the loopholes offered by grandfathering in old plans may actually prevent many insured from taking advantage of increased consumer protections. Any change to a grandfathered health plan should trigger it to give up its grandfathered status, unless the changes benefit the consumer.

Lawmakers must decide how much a health plan has to change and how much it can hold onto under its grandfathered status. For workers who are covered through their job, the decision could impact whether they have to change their insurer or how much their co-payment will be.

The Washington Post reports that plans will have to grapple with whether they cover breast cancer screenings without co-payments and limiting annual out-of-pocket expenses.

After the debate, a grandfathered plan could tailor its own benefits or be required to offer those required by the federal government. Denial for pre-existing conditions could be subject to new government rules and higher income employees may not be receive favorable coverage. And additional medical data may be required to be reported to the government.

The Post reports that health plans are constantly changing terms of coverage and switching from one provider to another making it nearly impossible for President Obama to promise you could keep your current health plan.

Meanwhile efforts are now underway in 33 states to block enactment of the provision of health care bill that everyone must buy insurance coverage or pay a penalty tax, also known as the individual mandate. Monday, May 24, is the deadline for Justice Department lawyers to file their response to the state of Virginia that say the individual mandate infringes on state statutes.

Florida, Arizona and Oklahoma are promoting a constitutional amendment on their ballots for November to prohibit the individual mandate. #

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