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Health Care / Health Care

Obama Admin Fills in Health Law Details

An illustration of health forms under a stethoscope and a pen. Health care, doctor, hospital patient,(iStockphoto)

The Obama administration filled in key details on how the health reform law will regulate insurance plans by issuing two long-awaited regulations on Tuesday.

*The new rules issued by the Health and Human Services Administration spell out how a centerpiece of the law—its requirement that insurers cover even sick or old applicants—will work. They also sketch out what minimum package of benefits must be included in health plans sold on state exchanges. Both rules will have a big impact on the insurance industry and will influence the cost of insurance. The rules are in draft form, which means there will be time for public comment and revisions before they are finalized.

*A rule on health insurance market reforms spells out how the health law's "guaranteed issue" and "community rating" requirements will work in practice. Those rules ban insurer discrimination against customers with pre-existing health problems and limit how much insurers can vary premium prices on the basis of age, tobacco use, family size and geography.

 

*Another rule underscores the law's requirement that all insurance products sold in state individual and small-group markets include a list of "essential health benefits." Through earlier guidance, HHS  has delegated some of that authority to states, which can customize their packages within certain parameters. But states have been eagerly awaiting more formal guidance so they can pick their plans and proceed with planning for implementation.

*A third rule gives guidance for employers that offer their workers wellness programs. The rule is designed to allow employers to offer some financial incentives for workers to stay healthy without discriminating against sick employees.

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