The Department of Health and Human Services has released some much-anticipated rules of the road that will help implement the Affordable Care Act, including requirements on essential health benefits and preventing discrimination against people with pre-existing conditions.
The first rule makes clear that insurance companies will have to comply with anti-discrimination requirements starting in 2014. Health insurance must be made available to everyone regardless of health status, and people with pre-existing conditions cannot be charged higher premiums. Premiums are allowed to vary according to certain factors, including age, smoking status, location and family size. But, coverage can’t be cancelled because of an illness.
A second rule lays out more detail regarding benefits that must be offered by states and insurance plans. This rule requires that every health plan for individuals and small businesses offer a core package of benefits, called essential health benefits. The requirements are grouped into 10 separate categories, including inpatient and outpatient care, maternity care, prescription drugs and laboratory services.
Finally, rules that govern the use of employer-provided wellness programs were issued. These popular programs encourage employees to meet certain health goals, such as losing weight, quitting smoking, or lowering cholesterol.
The rules could still change some, but there’s not much time for people to complain or ask for tweaks. The comment period ends Dec. 26.
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