A modest roundup of cost-related news.
Pregnancy blocks in individual health insurance plans — many individual health policies lack maternity-care coverage and feature costly add-ons.
“…individual health insurance policies generally don’t cover most of the expenses for a normal [pregnancy] delivery, according to a report last month by the House Energy and Commerce Committee, which investigated the offerings from the four largest for-profit health insurers: Aetna, Humana, UnitedHealth Group and WellPoint.
The findings are similar to those of a 2009 report by the National Women’s Law Center that examined 3,600 individual policies across the country and found that only 13% provided maternity coverage.
The problems don’t stop there. If a woman is pregnant and applies for coverage in the individual market, insurers generally consider her pregnancy a preexisting medical condition and deny coverage. Michelle Andrews, The Los Angeles Times, Nov. 29http://lat.ms/fpyyFS
Obama Administration Clashes With Insurers Over Controlling Costs
“Better coverage. Health insurance premiums lower than they would have been otherwise. Millions of Americans eligible for rebates in just a little over a year.
Those are some of the benefits the Obama administration continued to tout Tuesday, following up on Monday’s release of new rules to enforce the health law’s requirement that insurers spend at least 80 percent of their revenue on medical care or pay rebates to consumers.
But even as administration officials embark on a broad expansion of federal oversight of the health insurance industry, they’re up against this reality: Average Americans want premiums to go down, not just go up more slowly. And there’s no single magic bullet – not even the spending rules – that will do that.
Seemingly every premium increase is now blamed on the new law. In Tuesday’s press briefing, the administration again went on the offensive, saying that the law is responsible for only a small percentage of next year’s premium increases. Various studies, from consulting firms Mercer and Hewitt, have shown that the law is responsible for 1 to 2 percent of next year’s insurance premium increases. By Julie Appleby, Kaiser Health News, Nov. 23, http://bit.ly/gSzZoS
US mandates strict new cost management for health insurers
WASHINGTON — Health insurance premiums should go toward actual medical care — not insurers’ overhead and profits — the Obama administration said yesterday in rules that for the first time require the companies to give consumers a rebate. The regulation unveiled by the Health and Human Services Department calls for insurance companies to spend at least 80 cents of the premium dollar on medical care and quality. For employer plans covering more than 50 people, the requirement is 85 cents. Insurers that fall short of the mark will have to issue their customers a rebate. By Ricardo Alonso-Zaldivar and Tom MurphyAssociated Press / November 23, http://bit.ly/dSyqGa