Learn the Inside Scoop for Consumers on Health Care Reform

Learn the Inside Scoop for Consumers on Health Care Reform

Bonnie Burns, our Training and Policy Specialist, is serving on several National Association of Insurance Commissioners’ (NAIC) committees that are charged with developing standards for the Department of Health and Human Services (HHS) to use to implement various parts of the health care reform law. Many rules must be written in a short 3-year period to implement the regulations of health care reform by 2014. By this time, health care coverage must be available to everyone, even those with a health condition that makes them uninsurable today. Also, by 2014 no annual or lifetime limits on coverage, or low internal limits that unfairly restrict access to basic health care and treatment for serious illness will be allowed.

Burns recently published a report from her insider’s perspective on 4 topics likely to have the most profound effect on the health care coverage companies will market and sell consumers, particularly the pre-retirement population – people ineligible for Medicare ages 50-64. This population often has the toughest time finding and paying for health coverage when they don’t have it through an employer.

Burns specifically examines:

  1. Regulations on medical loss ratios (MLRs) – MLRs will determine what percentage of the premiums you pay will be spent on health care services covered by the plan, so you can get the most value for your premium dollars.
  2. Standards and disclosure on insurance companies� unreasonable rate increases – This will give you information about what costs a company used to seek a rate increase in your state so you can make informed choices about where you want to spend your premium dollars.
  3. Standardized definitions and terms to be used in health insurance contracts – This will help you understand the health care benefits you buy.
  4. Standardized summary of health care benefits – This will allow you to make side-by-side comparisons of health care coverage offered by different companies.

Burns also briefly discusses Exchanges, which will be the new marketplace for buying health care coverage in 2014.

To read the full publication, see: An Overview for Consumers: Selected Aspects of Health Care Reform.

See our Health Care Reform section for more information on health reform in general.

Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.