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New report: State action on Affordable Care Act's 2014 health insurance market reforms
Date:1/31/2013

s: Employers cannot impose waiting periods longer than 90 days before an employee can be eligible for coverage.
  • Rating Requirements: Insurers are restricted from using health status, gender, and other such factors in setting premiums.
  • Ban on Preexisting Condition Exclusions: Insurers cannot exclude or limit coverage for people with preexisting health problems.
  • Essential Health Benefits: Requires insurers to cover a comprehensive set of health benefits.
  • Out-of-Pocket Cost Limits: Holds out-of-pocket costs to the level established for high-deductible health plans that qualify for health savings accounts.
  • Actuarial Value: Requires insurers to cover at least 60 percent of total costs under each plan and sell plans that meet new benefit tiers based on average costs covered.

    For their study, the researchers reviewed actions taken by states and the District of Columbia to implement the 2014 reforms between January 1, 2010, and October 1, 2012. They found that states have taken the following steps:

    • One state, Connecticut, has passed legislation that addressed all seven of the new reforms.
    • Another state, California, passed legislation on six of the seven reforms.
    • Nine statesArkansas, Maine, Maryland, New York, Oregon, Rhode Island, Utah, Vermont, and Washingtonand the District of Columbia have passed laws or issued new regulations covering at least one of the seven new market reforms.

    According to the authors, future state action is critical. Without new legislation, regulators in at least 22 states would be limited in their ability to use all of the tools they need to protect consumers under the Affordable Care Act. The authors say that while states can use existing authority to promote compliance with many of the law's requirements, "questions remain about how effectively states can enforce the 2014 market reforms without new or expanded legal authority."

    "Because few states have taken f
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  • Contact: Mary Mahon
    mm@cmwf.org
    212-606-3853
    Commonwealth Fund
    Source:Eurekalert

    Page: 1 2 3 4

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