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Some insurers decided to stop quoting and writing new business in the child-only market because of concerns that parents would not quote and enroll children until they get sick. Insurers can charge higher rates for children, which is not prohibited by the Affordable Care Act but is permitted by state law.

The health insurance reform act that was passed in March requires that policies starting now or in the future cannot exclude, limit, or deny medical coverage to children under 19 based on any health problems that developed before seeking medical coverage. Therefore, there will be no more exclusions for children with pre-existing conditions.

Premiums could double for everyone by mid 2011. Your best choice is to buy health insurance now and lock in a low rate for several years. Many carriers allow you to lock in rates for more than a year at a very small cost per month.

These are some of the arguments of more than a dozen states that have filed lawsuits. The lawsuits challenge the constitutionality of the reform. Their arguments also include that the government should not force citizens to buy health insurance.

It will be several years before the reforms take effect, and opponents are trying to ensure that they never will.

But significant improvements have already been made and insurers are also moving into compliance ahead of schedule. New rules forbid insurance companies from denying coverage to children, young adults can now stay on their guardians’ policies until age 26, and setting a lifetime limit on benefits will be banned soon.

Let’s not forget the true objective and that is to reduce costs. The Obama administration  must demonstrate that reforms will eventually bring down costs. This is the true test.

In keeping with the spirit of health care reform, Aetna health insurance and Easy To Insure ME will work with clients to extend coverage to their medical plans’ current dependents ahead of schedule. This means current dependents under the age of 26 would not have to leave their plans when they would otherwise age out or are no longer full-time students (including those who would have lost eligibility effective May 31, 2010). Note that this would not include reinstatement of dependents who previously aged out of their plan. It also does not affect dental, vision, standalone pharmacy or other benefits.

For individual and small group medical plans (as defined in state law), Aetna health insurance will continue coverage effective June 1, 2010 for dependents under age 26 currently covered on a parent’s medical plan. Aetna health insurance will not change the plan’s premium until renewal.

For fully insured larger groups, and for all self-funded medical plans, Aetna health insurance will offer the option of expanding medical coverage for dependents under the age of 26 currently covered on a parent’s medical plan, effective on or after June 1, 2010. This would include dependents who would have aged out on May 31, 2010. Aetna will provide pricing for this plan design change, as appropriate, for plans that choose this option.

Regardless of whether a plan makes this change ahead of schedule, health care reform is bringing changes to all plans soon. On the next renewal date on or after September 23, 2010, all health insurance plans must cover all dependents up to age 26 (and older for insured plans in states that mandate coverage above age 26). This may include dependents who are not currently enrolled in the plan, in accordance with regulations. We will be able to tell you more when the federal government issues regulations telling insurers and employers how this must be administered.

Aetna is pleased to offer our plan members the ability to keep their dependents insured. This is one step toward the goal of health care coverage for all Americans.

Young adults will be able to continue to stay on their parents’ health plans (premium group or individual) up until age 26, regardless of their student, marital or employment status. It is important to note that any dependents who have dropped off their parents’ coverage earlier will not be eligible to come back onto those policies until their open-enrollment period.

Young Adults on Parents’ Health Insurance Plans. Young adults may stay on their parents’ health insurance until age 26, effective six months after enactment.

Prohibition on Pre existing Condition Exclusions for Children. Insurers are prohibited from excluding coverage of any  pre existing condition for children in the individual health insurance market, effective six months after enactment of the bill.

Prohibition Against Plan Rescissions. Carriers providing group or individual coverage are prohibited from rescinding coverage once an enrollee is covered under the plan, except in the case of an individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of the material facts. Effective six months after enactment of the law.

Prohibitions Against Lifetime Maximum Benefit Caps. Carriers providing group or individual coverage are prohibited from setting lifetime maximum limits on the dollar value of benefits and from setting unreasonable annual limits on the dollar value of benefits, effective six months after enactment.

National High Risk Pool. People with pre existing conditions who are uninsurable will be eligible for subsidized coverage through a national high risk pool, beginning 90 days after enactment.

Limits on Share of Private Premiums Insurers Spend on Non Medical Costs. New limits will be set for the percent of premiums that insurers can spend on non medical claim costs.

Annual Review of Health Premium Increases. Effective immediately, the HHS secretary and states will establish a new process for annual review of unreasonable insurance premium increases.

Elimination of Cost Sharing for Preventive Care in Medicare and Private Plans. In 2010, cost sharing for proven preventive care services is eliminated in both Medicare and private plans.

House members passed HB 2681 on a 70-23 vote and will help protect residents from some abortion funding. The bill strictly limits the use of public funds in health exchanges mandated by the new federal health insurance plan.

The Tennessee health insurance law states that “No health care plan required to be established in this state through an exchange pursuant to federal health care reform legislation enacted by the 111th Congress shall offer coverage for abortion services.”

Health Care Reform
President Obama Signs Final Health Care Bill into Law:  On Tuesday, President Obama signed into law the package of changes to the newly enacted Patient Protection and Affordable Care Act. Approved over unanimous Republican opposition in both chambers of Congress, this reconciliation bill increases the overall cost of the health care reform legislation by $65 billion, bringing the new total to $940 billion over the next 10 years.

What Does This Health Care Reform Legislation Mean: The biggest changes to the nation’s health insurance system will not take effect until 2014. Some of the changes include: the creation of insurance marketplaces called “exchanges” where people can shop for insurance; rules requiring insurers to accept all applicants, including those with pre-existing conditions; and an expansion of state Medicaid programs. Some additional provisions will become effective immediately while others will kick in later this year.

These are some of the features of the new health care overhaul bill passed through the reconciliation process and slated to begin to take effect in 2010:

• For new sales and subscribers who change policies after March 23, 2010, insurance companies will be required to make additional changes beginning in approximately 6 months, such as removing any member cost sharing for “preventive” benefits (as defined by the legislation). The renewal product requirements beginning for plan years 6 months after enactment include:

• Coverage for dependents up to age 26;

• Removal of limits on lifetime maximum benefits;

• Temporary federal high-risk pools; and

• Tax credits for small group employers.

Health Care Reform Impacts on Premiums: There are concerns that the new taxes on health insurance will likely increase premiums. Members of the news media report that under the health care overhaul , young adults who buy their own individual health insurance will carry a heavier burden of the medical costs of older Americans. This is expected to raise insurance premiums for young people when the plan takes full effect in 2014.

Additional Activities
Several Companies Push to Repeal Provision of Health Care Law: The American Benefits Council, an association representing hundreds of large corporations, urged President Obama and Congressional Democrats to repeal a provision in the health care bill that reduces the tax deductions allowed to companies that provide drug coverage for their retired employees. As a result of this impending provision, companies like AT&T, Caterpillar, Prudential, Deere Co. and 3M have all announced substantial charges against their first-quarter earnings in order to comply with federal accounting rules.

Insurers Will Comply With Law Regarding Children’s Coverage: This past week, despite vague language in the new health care law regarding coverage of children with pre-existing conditions, insurance companies assured HHS Secretary Kathleen Sebelius that they await clarification and will comply with the law, effective later this year.

Indiana health insurance Joins States’ Lawsuit Against Health Care Bill: In response to the new health care reform legislation, the Attorneys General of several states across the country filed lawsuits arguing against the constitutionality of requiring Americans to purchase health insurance. This week, the state of Indiana joined 13 others in a lawsuit filed last week in a Florida federal court. The 14 states – Indiana, Florida, Alabama, Colorado, Idaho, Louisiana, Michigan, Nebraska, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington – will become joint plaintiffs in the suit and split the costs of the legal challenge.

Doctors Group Files Lawsuit to Repeal Health Care Legislation: The Association of American Physicians and Surgeons filed a lawsuit in the U.S. District Court for the District of Columbia against HHS Secretary Kathleen Sebelius and Social Security Administration Commissioner Michael Astrue. Attorneys for the group argue that the insurance mandate is unconstitutional. They also argued against the constitutionality of other provisions saying, “If the bill goes unchallenged, then it spells the end of freedom in medicine as we know it.”

Public Opinion
More Americans Disapprove of President’s Handling of Health Care: In a recent CNN poll, 54 percent of Americans said they disapprove of the way President Obama is handling health care reform, while 45 percent approve. In addition, 56 percent of respondents feel the Democrats’ health care legislation creates too much government involvement in the nation’s health care system.

Americans Unhappy over Health Care Reform Passage: In a recent USA Today/Gallup poll, 50 percent of Americans said the recent passage of health care reform legislation is a bad thing. Further, 55 percent say health care costs in the U.S. will rise as a result of the bill.

Two Polls Offer Different Results:  In a newly released Rasmussen report, 54 percent of Americans favor repealing the recently enacted health care legislation. Further, 49 percent believe the new law will reduce the quality of care, while 60 percent think it will increase the federal budget deficit. In contrast, supporters of reform are touting the recent CNN poll that shows 50 percent of Americans are either fine with the new legislation or would favor seeing more government involvement in health care. In this poll, only 47 percent of Americans favor repealing the bill.

Looking Ahead
Late this week , President Obama traveled to the swing states of Maine and North Carolina to discuss details of the new health care reform law and its effects on unemployment and small business. At the same time, Republicans continue to debate how best to leverage growing discontent over the bill and its implications in the months leading up to the November elections. In the meantime, it’s within federal agencies such as HHS that much of the detail, timing and how-to questions will be worked out going forward.