Thursday, April 29, 2010

Fun Facts about Health Reform

WonkRoom published several facts about health reform. The first deals with the practice of rescissions:

Federal law has required insurers to end rescissions since Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996. That law gave states the authority to enforce the rescission ban, but permitted the federal government to take over if states failed to adequately protect consumer interests.

Over the last 14 years, insurers have been able to take advantage of weak state regulations to purge their rolls of costly patients without triggering a response from the federal government. What’s still unclear is how or if the federal government will enforce the rescission requirement under health reform. The new law restates the rescission prohibition and leaves enforcement of the rule to the states. The federal government is again the regulator of last resort.

Health reform institutes the same structure that worked so poorly for 14 years? It gets better. Insurance companies "medical costs", a key part of the medical loss ratio, will be defined by an industry group.

The health care law tasks the National Association of Insurance Commissioners — a private body not subject to federal transparency rules and largely funded by the insurance company — with defining the standard definitions, “subject to the certification of the Secretary.”

Couldn't Congress find any accountants or actuaries to craft operational definitions? For-Profiteers win again.

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