Why is this important to me?
Health insurers would be able to vary their premiums based only on age, tobacco use, family size or geography under proposed U.S. rules meant to protect people with pre-existing illnesses.
The Department of Health and Human Services outlined conditions and services insurers must cover, and laid out rules to let companies expand employee wellness programs, according to proposed regulations posted online today. The rules also include a concession to pharmaceutical companies that may force health plans to offer a wider variety of branded drugs.
The proposals mark the Obama administration’s move to begin formalizing core provisions of the 2010 Affordable Care Act. The first rule targets 50 million to 129 million Americans who have conditions such as diabetes and cancer that insurers have cited to deny coverage or increase premiums, the department said in its filing. That practice would have to end in 2014.
The ban on medical underwriting “is of course intensely important to cancer patients and survivors who for too long have been charged exorbitant rates or denied care altogether,” said Stephen Finan, senior director of policy at the American Cancer Society’s lobbying arm, the Cancer Action Network.
Insurers will be able to vary premiums based on age, and are limited to charging their oldest customers three times as much as their youngest ones. The regulation must go through a public comment period and may change before taking effect.