The nation’s health insurance plans have proposed to guarantee coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate. Under the proposal, health plans participating in the individual health insurance market would be required to offer coverage to all applicants as part of a universal participation plan in which all individuals were required to maintain health insurance, said America’s Health Insurance Plans (AHIP). The new proposal builds on the series of comprehensive reform plans that AHIP’s board of directors began releasing in November 2006.
Elements of the AHIP proposal are:
- Guarantee-issue coverage with no pre-existing condition exclusions.
- Establish an individual coverage requirement with an insurance coverage verification system, an automatic enrollment process and effective enforcement of the requirement that all individuals purchase and maintain coverage.
- Promote affordability by: providing refundable, advanceable tax credits for moderate-income individuals and working families and promoting tax equity whether coverage is obtained through an employer or the individual market.
- Ensure premium stability for those with existing coverage through a broadly funded reimbursement mechanism that spreads costs for the highest-risk individuals.
Health plans also said that premium support for moderate-income individuals and broad spreading of risk was necessary to promote affordability and maintain premium stability in the individual health insurance market.
To ensure that all Americans can access coverage, health plans also reiterated their long-standing support for making eligible for Medicaid every uninsured American living in poverty and strengthening the Children’s Health Insurance Program.
The announcement follows a nationwide listening tour conducted by AHIP as part of its Campaign for an American Solution. Concerns about coverage for pre-existing conditions, continuity of coverage for those between jobs and maintaining affordability for those with insurance were raised repeatedly across the country.
Address: America’s Health Insurance Plans, 601 Pennsylvania Avenue NW, South Building, Suite 500, Washington DC 20004; (202) 778-3200, http://www.ahip.org.
Get the news you need on managed care when you sign up for a FREE 30-day trial subscription to the Executive Report on Managed Care. To sign up today,
click here.
Source: Executive Report on Managed Care, December 2008
The Executive Report on Managed Care
The Executive Report on Managed Care will provide you with twice-monthly news and information on issues affecting the managed care industry, legislation and regulations, real-life examples of how managed care organizations are benefiting from innovative programs and cost saving initiatives.
The Executive Report on Managed Care is available from the Healthcare Intelligence Network for $457 by visiting our
Online Bookstore or by calling toll-free (888) 446-3530.
