Health Insurance Market Reform

We have been getting quite a bit of questions lately regarding health insurance market reform, specifically as it relates to adults and children with disabilities. While there are many new provisions, there are two that I think have direct impact. The first one is that as of 2014 health insurers will no longer be able to discriminate against people due to disabilities or other pre-existing conditions. Health insurers will no longer be allowed to deny coverage, charge higher premiums, exclude benefits relating to pre-existing conditions, rescind coverage after someone is injured or acquires a new condition, or impose annual caps on benefits. For children, most of these provisions go into effect for children in September 2010. The second provision has to do with lifetime caps on benefits which are prohibited immediately. Between now and 2014, the Secretary of Health and Human Services (HHS) may restrict annual caps on benefits on benefits. As of 2014 both lifetime and annual caps on benefits are prohibited.

When my girls were younger I can recall many an instance where friends of ours who had children with special needs were at a complete loss when their children would reach their lifetime health benefits by their first or second birthday. This will certainly make a difference to families in those situations.