Employers Eye Bare-Bones Health Plans Under New Law

[ProSense]

12. The WSJ

Employers are increasingly recognizing they may be able to avoid certain penalties under the federal health law by offering very limited plans that can lack key benefits such as hospital coverage.

...is full of shit. Employers must provide the essential health benefits or pay a fine. They can chose not to provide the coverage, but they will be subjected to a fine. How on earth are people getting duped by this article? The law did not reduce existing coverage. In fact, the minimum package is better than the existing requirement.

HHS releases draft rules on key elements of Obamacare, including pre-existing conditions

by Joan McCarter

Yes, President Obama won reelection and the Affordable Care Act is the law of the land. On Tuesday, the Department of Health and Human Services released proposed regulations on some of the key elements of health insurance reform in the law, including how insurers can vary premiums based on age, tobacco use, family size and geography, proposed rules for essential health benefits, and rules governing employer-based wellness programs. These are the draft rules, with comment period open for the next month.

For the majority of the uninsured, the key rules are the market reforms, the rules that prevent insurers from denying coverage because of pre-existing conditions, and that set the limits on how insurers can vary premiums, limiting the variation to age (within a 3:1 ratio for adults), tobacco use (within a 1.5:1 ratio and subject to wellness programs in group insurance), family size and geography. That means that insurers can no longer charge exorbitant premiums as individuals age, or for smokers. Nor can they charge higher premiums because you have lady parts. Also prohibited is charging more based on occupation, past health problems, or employer size or industry. What's more, insurers will be prohibited from refusing to renew coverage because an individual or employee becomes sick or has a pre-existing condition.

The essential health benefits rules establish 10 categories in which services must be included in health plans: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services (including behavioral health treatment), prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including oral and vision care. Health plans offered in the individual and small group markets, including both those in the exchanges and in the existing market, have to offer a core package of items and services in those categories.

The third set of rules provides the requirements for employer wellness programs. These programs have to be "reasonably designed to promote health or prevent disease," meaning that they can't set unreasonable or unobtainable goals and rewards to employees. They have to establish alternative health standards that can be met by all people, including those "whose medical conditions make it unreasonably difficult, or for whom it is medically inadvisable, to meet the specified health-related standard."

This is the stuff health insurance reform was all about, the core regulations that will make health insurance affordable and accessible. They're also the parts of reform that will be most popular and important to the public. This is the stuff Republicans absolutely did not want to see implemented, and the stuff that will make "Obamacare" be as much an appreciated part of the nation's health care system as Medicare.

http://www.dailykos.com/story/2012/11/20/1163479/-HHS-releases-draft-rules-on-key-elements-of-Obamacare-including-pre-existing-nbsp-conditions

Hobby Lobby Must Cover Contraception For Employees, Judge Rules
http://thinkprogress.org/health/2012/11/19/1219011/hobby-lobby-judge/

http://www.democraticunderground.com/10021858364

New Federal Rule Requires Insurers to Offer Mental Health Coverage

By ROBERT PEAR

WASHINGTON — The Obama administration issued a final rule on Wednesday defining “essential health benefits” that must be offered by most health insurance plans next year, and it said that 32 million people would gain access to coverage of mental health care as a result.

The federal rule requires insurers to cover treatment of mental illnesses, behavioral disorders, drug addiction and alcohol abuse, and other conditions.

Kathleen Sebelius, the secretary of health and human services, said that in addition to the millions who would gain access to mental health care, 30 million people who already have some mental health coverage will see improvements in benefits.

White House officials described the rule as a major expansion of coverage. In the past, they said, nearly 20 percent of people buying insurance on their own did not have coverage for mental health services, and nearly one-third had no coverage for treatment of substance abuse.

- more -

http://www.nytimes.com/2013/02/21/health/new-federal-rule-requires-insurers-to-offer-mental-health-coverage.html

http://www.democraticunderground.com/10022407451

The WSJ has been working to undermine the law since it was passed.

Wrong on Obamacare, WSJ editorial board searches for new spin
http://www.democraticunderground.com/10022846359