Study: Most Individual Health Plans Fall Short of Reform Law Standards
More than half of all health insurance policies currently available to individuals do not meet the standards of coverage established by the federal health reform law and fall short of what will be required of plans sold through the insurance exchanges beginning in 2014, according to a study published Wednesday in the journal Health Affairs, the New York Times reports (Abelson, New York Times, 5/23).
For example, the overhaul will require providers of the most basic insurance policies to cover 60% of a policy's total cost to receive clearance for sale in the exchanges (Baker, "Healthwatch," The Hill, 5/23).
The authors of the study -- which was funded by the Commonwealth Fund -- found that most of the individual policies they reviewed now covered less than that threshold (Sanger-Katz, National Journal, 5/23).
The researchers also found that many of the policies do not include medical spending limits, forcing some families with high medical bills to pay as much as $27,000 or more in out-of-pocket costs for their care. The health reform law caps the amount that consumers spend on medical bills annually and over their lifetime, the Times reports.
Health plans in the exchanges also will have meet other minimum requirements that many plans now do not, such as providing coverage for pre-existing medical conditions and maternity care.
Meanwhile, the study noted that individuals with employer-sponsored health coverage have policies that already meet the federal standards (New York Times, 5/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.