Seven Health Reform Provisions That Could Take Effect This Year

Joe Cantlupe, for HealthLeaders Media , January 14, 2010

Although the House and Senate negotiators are still hammering out their plans for healthcare reform, lawmakers and healthcare stakeholders are playing a numbers game: carefully eyeing when specific projects are to be implemented and gauging how they can meet the deadlines.

As far as healthcare leaders are concerned, meeting some of the timelines—especially for 2010—may be, in the words of one, "challenging."

Under the proposed healthcare reforms before the House and the Senate, both have differing expectations, as well as differing deadlines, with some to take effect this year and others to continue through at least 2018.

"Changes that take effect in 2010 need to be carefully rolled out to avoid disruption for those with existing coverage," says Tom Epstein, vice president for public affairs, Blue Shield of California.

Epstein says Blue Shield of California, similar to other insurers, are taking steps internally to prepare for the changes.

"Some deadlines may change as a result of the negotiations that are currently underway," Epstein says. "We are forming a broad-based reform implementation group this month to begin planning for transition."

If Congress passes health reform soon, some changes may be implemented in 2010 under the legislative proposals. The plans for relatively quick implementation include:

  • Provisions to prohibit health insurance rescissions when a person gets sick
  • New limits on pre-existing condition exclusions
  • Proposals to prohibit insurance companies from placing lifetime caps on coverage
  • Creation of new long-term care programs
  • Creation of a health benefits advisory committee
  • A $5 billion fund to finance an immediate temporary insurance program for those who are deemed uninsurable because of pre-existing conditions
  • Proposals for incentive payments to states that enact alternative medical liability laws

The "reforms scheduled for 2010 may be challenging," Epstein said. He adds, however, "we should be able to meet the deadlines for reforms that take place in 2013 or 2014. From an operational perspective, there is little difference between 2013 and 2014."

Diane Boyle, vice president of the National Association of Insurance and Financial Advisors, says NAIFA has concerns about reforms implemented this year because "we have lots of policies in place and no room for adjustments." The NAIFA has actively opposed proposed amendments to repeal long-standing provisions of the McCarran-Ferguson Act related to health and medical malpractice insurance.

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