White House to Health Insurers: Big Changes Are Coming

medical rules
medical rules

Most health insurers will soon be banned from rejecting children with preexisting medical conditions under provisions contained with new health-care overhaul legislation, the White House said Tuesday. The benefit is just one of several safeguards the administration detailed as officials met privately with state insurance commissioners and insurance company executives.

Among other benefits, the plan's "patients' bill of rights" also imposes a ban on lifetime coverage limits. More than 100 million insureds currently face such limits. The plan also gradually phases out annual coverage limits. Beginning this year, plans can set set yearly limits no lower than $750,000, rising to $2 million by 2012, and eliminated altogether by 2014, when the full force of health-care overhaul law takes effect.

The patients' bill of rights also forbids insurers from canceling the policies of those who get sick, and erroneous errors on application forms can't be used as a reason to revoke coverage. The plan also provides patients a choice of primary-care physicians and pediatricians from plans' networks. Women will also be able to see an ob-gyn without a referral, and patient will need to seek approval to for out-of-network emergency care.

The new rules apply to most health plans except those that have been "grandfathered" in under the new law.

Speaking after the meeting, Obama warned insurance firms not to use his health care overhaul as a chance to enact big rate increases and said the federal government would work with states to monitor them, Reuters reported. "Insurance companies ... shouldn't see it as an opportunity to enact unjustifiable rate increases," Obama said.

Patients have a right to be concerned. Consumers who buy their policies directly from insurance companies face increases averaging 20% this year, according to a survey released Monday by the Kaiser Family Foundation. Most people in the U.S. get health insurance through their employer, but about 14 million people under age 65 have coverage through the non-group or individual market, according to the survey.

Obama also said he'd fight efforts by Republicans to repeal the health care bill. "We're not going back," the president said, speaking at an event marking 90 days since he signed health-care overhaul legislation into law. "I refuse to go back," he said. "And so do countless Americans."