Drug Discovery and Development

  • Home Drug Discovery and Development
  • Drug Discovery
  • Women in Pharma and Biotech
  • Oncology
  • Neurological Disease
  • Infectious Disease
  • Resources
    • Video features
    • Podcast
    • Voices
    • Webinars
  • Pharma 50
    • 2025 Pharma 50
    • 2024 Pharma 50
    • 2023 Pharma 50
    • 2022 Pharma 50
    • 2021 Pharma 50
  • Advertise
  • SUBSCRIBE

More Health Care Reform Provisions Around The Corner

By Drug Discovery Trends Editor | August 4, 2010

Health care reform hits another milestone next month, with new provisions that include a coverage expansion for young adults and restrictions on an insurer’s ability to impose annual coverage limits or to reject children with pre-existing medical conditions.

Insurance coverage that starts on or after Sept. 23 will have to comply with these changes and others that were put in place when President Barack Obama signed the health overhaul into law March 23. For most people, the changes won’t affect their plans until coverage renews in the weeks or months that follow. Here are the highlights:

– Adult children up to age 26 will be able to receive dependent coverage with all individual and group policies.

– Lifetime limits on the dollar value of insurance coverage will be prohibited. This refers to how much your insurance coverage pays out to cover claims.

– Restrictions will be placed on annual limits for coverage, a practice that will prohibited in 2014.

– Insurers will be prohibited from rescinding or canceling coverage except in cases where the customer commits fraud.

– Insurers will not be able to exclude children from coverage because of a pre-existing condition, but they can require parents to sign up kids only during a fixed annual enrollment period to ensure they don’t wait until a child gets sick to buy coverage.

– Insurers will be required to provide preventive care like immunizations or mammograms without charging co-pays or other forms of cost sharing. Some may not have to comply with this element if their coverage existed March 23 and has not changed substantially.

Individual plans that have so-called “grandfathered status” like this also will not have to immediately follow the new restrictions on annual coverage limits or eliminate their lifetime caps. Over time, most plans will lose their grandfathered status as they make changes in benefit designs, said Jennifer Tolbert, a health policy analyst with the Kaiser Family Foundation.

Tolbert said these early provisions of the new law focus in part on consumer protections.

“It’s basically improving the quality of coverage that people have,” she said.

However, insurers and benefits analysts have cautioned that these restrictions and coverage expansions will raise the cost of insurance for some customers.

Several provisions of the complex law started unfolding in the weeks after President Obama signed it. For instance, people with Medicare prescription drug coverage are receiving $250 rebates once they reach a gap in their coverage known as the “doughnut hole.”

Enrollment has started in some states for temporary insurance that will cover people with pre-existing medical conditions who have been uninsured for at least six months. Some small businesses that offer employee health coverage can seek tax credits that will apply for this year.

The law will continue to develop over the next several years. In 2011, insurers will be required to offer rebates if they don’t spend a minimum percentage of their premiums on medical costs. Details of that provision are still being worked out.

Some of the biggest reform provisions start in 2014.

By then, Medicaid will be expanded to reach more people. Most citizens and legal residents will be required to have health care coverage, and many will receive help from the government through income-based tax credits when they shop for coverage on health insurance exchanges.

Date: August 3, 2010
Source: Associated Press


Filed Under: Drug Discovery

 

Related Articles Read More >

Sanders, King target DTC pharma ads but the industry worries more about threats to its $2B R&D model
Zoliflodacin wins FDA nod for treatment of gonorrhea
FDA approved ENFLONSIA for the prevention of RSV in Infants
First clinical study results of Dupixent for atopic dermatitis in patients with darker skin tones 
“ddd
EXPAND YOUR KNOWLEDGE AND STAY CONNECTED
Get the latest news and trends happening now in the drug discovery and development industry.

MEDTECH 100 INDEX

Medtech 100 logo
Market Summary > Current Price
The MedTech 100 is a financial index calculated using the BIG100 companies covered in Medical Design and Outsourcing.
Drug Discovery and Development
  • MassDevice
  • DeviceTalks
  • Medtech100 Index
  • Medical Design Sourcing
  • Medical Design & Outsourcing
  • Medical Tubing + Extrusion
  • Subscribe to our E-Newsletter
  • Contact Us
  • About Us
  • R&D World
  • Drug Delivery Business News
  • Pharmaceutical Processing World

Copyright © 2025 WTWH Media LLC. All Rights Reserved. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of WTWH Media
Privacy Policy | Advertising | About Us

Search Drug Discovery & Development

  • Home Drug Discovery and Development
  • Drug Discovery
  • Women in Pharma and Biotech
  • Oncology
  • Neurological Disease
  • Infectious Disease
  • Resources
    • Video features
    • Podcast
    • Voices
    • Webinars
  • Pharma 50
    • 2025 Pharma 50
    • 2024 Pharma 50
    • 2023 Pharma 50
    • 2022 Pharma 50
    • 2021 Pharma 50
  • Advertise
  • SUBSCRIBE