Labor & Employment Law

Affordable Health Choices Act

For those feeling too inundated to follow the debate on health insurance at the federal level, here's a basic overview of the what has come out of Senate's Senate's Health, Education, Labor and Pensions (HELP) Committee on this subject.

Affordable Health Coverage:

• Prohibiting Discrimination Based on Health Status. In issuing health insurance policies, insurers will not be permitted to establish terms of coverage based on any applicant's health status, medical condition (including physical and mental illness), claims experience, prior receipt of health care, medical history, genetic information, evidence of insurability (such as being a victim of domestic violence), or disability. (§2706)

• Ensuring the Quality of Care. Health insurance policies will be required to include financial incentives to reward the provision of high quality care that include case management, care coordination, chronic disease management, wellness and health promotion activities, child health measures, activities to improve patient safety and reduce medical errors, as well as culturally and linguistically appropriate care. (§2707)

• Extension of Dependent Adults: All individual and group coverage policies will be required to continue offering dependent coverage for children until the child turns age 26, according to regulations to be established by the Secretary of Health & Human Services. (§2709)

• No Lifetime or Annual Limits. No individual or group health insurance policy will be permitted to establish lifetime or annual limits on the dollar value of benefits for any enrollee or beneficiary. (§ 2710)

Shared Responsibility for Health Care:

• This subtitle creates a shared responsibility framework. Individuals will be required to have health coverage that meets minimum standards and to report such coverage annually. Exemptions will be made for individuals unable to access affordable care. Fees will be assessed on employers who do not provide qualifying coverage for full- and part-time employees. Employers with 25 or fewer employees are exempt from penalties. Standards will be established to ensure efficient use of health information technology for enrollment in qualified health plans.

For those with  ALOT of free time on their hands, follow this link to the Committee's Release: In Historic Vote, HELP Committee Approves the Affordable Health Choices Act

Full post as published by Strategic HR Lawyer on July 15, 2009 (boomark / email).