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.
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.
Ways and Means health panel Chair Pete Stark (D-Calif.) said, “Plain and simple, insurance companies can’t be trusted.” This comment was Stark’s response to the announcement that most insurance companies will no longer sell new individual policies for children under 19 as health reform now prohibits pre-existing conditions exclusions.
While I understand that this is a sensitive and important topic, I am still amazed at how much negative press insurance companies are receiving for 3 reasons.