What to watch for: Resistance from employers, who may not be too keen on paying more money to insure their workers’ young adult children. While it’s a good bet that insurers would relish new business and more premiums from younger and healthier people, they just might find it more lucrative to send all these young people into the individual market rather than keep them on family coverage.
Guaranteed Insurance Renewal. The White House says that insurance companies will be required to renew any policy as long as the policyholder pays the premium in full, and won’t be allowed to cancel anyone who gets sick. Mr. President, take note. HIPAA already says that all kinds of health insurance policies are guaranteed renewal—job-based coverage and individual health insurance. So what’s new here? Is this an attempt to deal with rescission, that onerous individual-market practice where insurers drop coverage claiming that a policyholder lied or failed to disclose information on the application?
What to watch for: Will insurers fight for language that continues to allow rescissions? Watch for language that allows rescissions for fraud and misrepresentations. If there are new rights to coverage and prohibitions on carriers from discriminating against people with preexisting conditions, there should be no incentive for fraud or misrepresentation, whether intentional or unintentional.
Journalists, this is where the action is going to be if a bill moves forward in the Congress. If ever there was a time to watch the backroom politics of insurance reform, it is now. The AP moved a story yesterday that at first I thought was promising. “Consumer protections lost in health care debate,” the headline said. But the story was disappointing, missing a chance to explain and analyze exactly what these protections are, and how they might get watered down. Instead, the story was a collection of graphs, a couple of which noted how insurers could no longer base premiums on someone’s medical history. It included a few quotes from Washington wonks, and talked about the age rating that would be allowed by the House and Senate bills.
The story did deliver one takeaway for readers who might be tempted to think their problems getting insurance and staying insured are about to be solved. The AP said the protections would not be available until 2013. That’s a long time to wait if you need medical care—and a way to pay for it.