HHS issued two rules on August 1st addressing the preventive care requirements in the Patient Protection and Affordable Care Act (PPACA). The first is a proposed rule, which would require new health insurance plans to cover women’s preventive services without charging a co-payment, co-insurance or deductibles for plan years starting on or after August 1, 2012. The requirement will not apply to grandfathered plans that were in effect before the law was enacted on March 23, 2010.

The first “unintended consequence” of the Patient Protection and Affordable Care Act (PPACA) addressed in Part 1 of the blog described how routine physical exams were not specifically listed as a preventive service under health reform so insurance companies do not have to cover this service. The second “unintended consequence” of health reform addressed in Part 2 of the blog revealed how most insurance companies are not offering individual insurance policies to children under 19 since they are prohibited from applying pre-existing conditions exclusions. The third and final “unintended consequence” of health reform that I will discuss relates to dependent children under the age of 26 staying on their parents’ plans.

The first “unintended consequence” of the Patient Protection and Affordable Care Act (PPACA) addressed in Part 1 of our blog described how routine physical exams were not specifically listed as a preventive service under health reform so insurance companies do not have to cover this service. Today, we will discuss the second “unintended consequence” of health reform, which addresses how new individual insurance policies are prohibited from applying pre-existing conditions exclusions for children under 19.

Wikipedia states that the law of unintended consequences is a warning that an intervention in a complex system always creates unanticipated and often undesirable outcomes. Unfortunately, health reform has “unintended consequences” written all over it. Three specific examples include: preventive care, no pre-existing conditions for children under 19, and dependent children under the age of 26 staying on parents’ plans. I’ll focus on the first topic today: preventive care.

On May 31, 2011, the U.S. Department of Health and Human Services (HHS) announced that premiums will be reduced and eligibility requirements will be eased when enrolling in the federally administrated Pre-Existing Condition Insurance Plan (PCIP).

The DOL, HHS, and IRS issued Part VI of the FAQs regarding implementation of the market reform provisions of the Affordable Care Act and focus on grandfathered health plan provisions of health care reform. For simplicity, only the questions are included below. You may view the government’s response here or read our previous blog articles regarding FAQs Part I, Part II, Part III, Part IV and Part V.

The DOL, HHS, and IRS jointly issued another set of FAQs (Part V) regarding implementation of the market reform provision Affordable Care Act, with topics including auto-enrollment in group health plans, summary of benefit disclosure requirements to group health plan participants, grandfathered plans, dependents to age 26 requirements, preexisting condition requirements for children in individual health policies, and value-based insurance design in connection with preventive care benefits.

Are you aware that beginning January 1, 2011, if you are enrolled in either a Medicare Advantage Prescription Drug Plan (MAPD) or Prescription Drug Plans (PDP) and are a high-income individual, you will pay higher Part D premiums as a result of PPACA?

The DOL, HHS, and IRS jointly issued another set of FAQs (Part IV) regarding implementation of the market reform provisions of the Affordable Care Act. For simplicity, only the questions are included below. You may view the government’s response here or access FAQs Part I, Part II and Part III.

There have been a few articles published regarding the fact that the baby boomers, those individuals ages 50 to 64, may have the most to gain from the new health care law. An article from CQ HealthBeat (12/15, Norman, subscription required) states that this particular age group is feeling the pinch of the economy and has the highest rates of unemployment. The article goes further to say that the creation of a new high risk pool with no pre-existing limitations, elimination of annual limits and lifetime maximums, and coverage for preventive services will benefit this age group significantly.