Abortion banned in high-risk pools and insurers start issuing child policies again

[Greenbeard]

I didn't see any updates to the existing threads on these issues today, so here's a new one.

Federal rules out today ban abortion coverage in the new high-risk pools:

Elective abortions will be prohibited and people with pre-existing conditions will be able to get comprehensive benefits without paying any more than healthy people, under new federal regulations for high-risk health insurance pools released today by the Obama administration.

The state-based pools provision is one of the high-profile features of the new health law taking effect this year. It allocates $5 billion to create plans to cover people who have been uninsured for at least six months and have a pre-existing health condition.

The 108-page rule detailing how the new plans will work won praise from consumer advocates for helping to make insurance more affordable and from Republicans, who had opposed any coverage of abortion except in cases of rape, incest or the life of the mother.

"It appears the rule includes a strong prohibition on federal coverage of abortion," said Jessica Straus, spokeswoman for Sen. Michael Enzi, R-Wyo., who along with a dozen other Senate Republicans earlier this week called on the administration to make sure the plans did not cover abortion.

John Hart, a spokesman for Sen. Tom Coburn, R-Okla., added: "Dr. Coburn is pleased (HHS) Secretary (Kathleen) Sebelius is taking to heart our concerns that the health care law will fund abortion. He’s still reviewing the new regulations but is encouraged they are making a serious attempt to address the problem."

The benefits in the new plans would be similar to those given to members of Congress and other federal government workers, the regulations said. Covered benefits include hospitalization, outpatient care, maternity care and home health care. . .

More details about the coverage available at that link.

Meanwhile, guidance released by HHS two days ago is assuaging the concerns of insurers who had halted or threatened to halt the issuing of new policies for children:

Health insurance plans across the country on Wednesday began to backtrack on their decision to pull out of the child-only coverage market after the Obama administration addressed their concerns about the potential damage to their bottom lines.

The Department of Health and Human Services (HHS) on Tuesday clarified regulations mandating that insurance plans agree to cover sick children. HHS made it clear that plans are free to set up specific enrollment periods for their insurance plans if allowed under state laws.

The new rules apply to plans in the individual and group markets from Sept. 23.

Health plans had raised concerns that without the enrollment periods, parents could wait until their children get sick before seeking coverage, making it impossible for insurers to stay profitable.

The insurance industry quickly applauded the new guidance. And at least one insurer, Blue Cross Blue Shield of Florida, announced it was “pleased to announce that it will establish a process to resume the sale of Child Only policies.”

“We think this policy will ensure that children get the comprehensive coverage they need while avoiding this unintended consequence,” Scott P. Serota, president and CEO of the Blue Cross and Blue Shield Association, said in a statement. “This is consistent with other public and private health insurance programs.”

Karen Ignagni, president and CEO of America’s Health Insurance Plans, followed suit.

 

[Quantum Windbag]

So, rates for healthy people will go up. Nice to see I was right about that all along.

 

[auditor0007]

It's interesting that insurance rates will go up for healthy people considering that the high risk pool insurance is no bargain. I have not yet seen the rates for Ohio as it will be run by a private insurance company rather than the federal government. But looking at rates from states run by the federal government, the rates I would be paying are around $500 per month with a $2500 deductible. I am not sure if the deductible must be fully met before coverage kicks in or if doctors visits are covered with a co-pay. Either way, for most, coverage won't kick in before the insuree pays between $8000 to $8500. And then there is still another $3450 that must be paid before the insurance pays 100%. So, for anyone with serious health issues, they will be paying around $14,000 per year.

In effect, this will exclude a great many people as they just won't be able to afford it. Comparing current rates for a similar plan for a so-called healthy person, the cost is under $200 per month. And a healthy person is not going to pay much if anything in deductibles if they are not sick. So for me, all this whining is about nothing at all. If you're healthy, it's not going to cost you a fortune. I realize that in certain states such as New York, rates are considerably higher. But overall, for most, this is an accurate assessment.

To be honest, I'm not certain how many people will be able to afford this high risk coverage. I guess only time will tell. The real ramifications will occur once these insurance companies are required to accept everyone at the same rates regardless of pre-existing conditions.