· June 12, 2012

Insurers embrace some provisions of Affordable Care Act

UnitedHealthcare, the nation’s largest insurer, announced yesterday that it will maintain certain provisions of the Affordable Care Act (ACA) regardless of the pending Supreme Court ruling. The company’s president notes that these provisions not only improve access to healthcare but also help stem the rising costs of healthcare. Aetna and Humana were quick to follow UnitedHealthcare’s lead, announcing similar policies. The decisions point to the need for and popularity of elements of the ACA. Among provisions UnitedHealthcare announced it was keeping include:

• Preventive health services without co-pays This includes yearly preventive visits, screening for high blood pressure and diabetes, and all standard immunizations. This also includes women’s preventive health care, such as mammograms, screenings for cervical cancer and other services.

• Dependent coverage until age 26 Parents can include children up to 26 on their policies regardless of whether they are enrolled in school, married or dependents for tax purposes.
• Eliminates lifetime coverage limits Ends the practice of cutting off insurance coverage once spending thresholds have been reached; as a result, patients no longer need to fear bankruptcy as a result of extended illness.

• Patient policies cannot be retroactively terminated or cancelled, except for failure to pay

• Providing clear and timely options for appeal

Not included, however, are many of the benefits for consumers included in the ACA. For example, insurers did not agree to end the practice of gender rating, or charging a woman more for insurance solely based on gender. This unfair practice costs women in Ohio millions of dollars a year. Further, the insurance companies did not agree to cover those with pre-existing conditions.  The number of individuals with preexisting condition is alarmingly high—it is estimated that 1 in 5 non-elderly americans are uninsured as a result of preexisting conditions. Without the ACA it will continue to be difficult for these individuals to find coverage. So while it’s good that consumers will get these few benefits regardless of what the Court does, the biggest problems for consumers will still remain if the ACA goes down: namely, no pre-existing condition coverage for 30 million Americans who now don’t have it, nothing in the area of cost containment and no protection for women from paying more than men. That is why we still need the ACA.