Preexisting Conditions and Healthcare Coverage
Erschienen am 1. März 2021
394 Seiten
978-1-5361-9403-6 (ISBN)
Beschreibung
In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person''s health insurance went into effect. A pre-existing condition can be something as common as high blood pressure or allergies, or as serious as cancer, type 2 diabetes, or asthma-chronic health problems that affect a large portion of the population. Americans with preexisting conditions need health insurance. This book looks at the legislation concerning preexisting conditions.
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Inhalt
- Intro
- Contents
- Preface
- Chapter 1
- Examining Threats to Workers with Preexisting Conditions*
- Prepared Statement of Hon. Robert C. "Bobby" Scott, Chairman, Committee on Education and Labor
- Prepared Statement of Hon. Virginia Foxx, Ranking Member, Committee on Education and Labor
- Testimony of Sabrina Corlette, Research Professor, Center on Health Insurance Reforms, Georgetown University Health Policy Institute
- The ACA Corrected Many Problems in a Dysfunctional Insurance Market
- Problems with Access
- Problems with Affordability
- Problems with Coverage Adequacy
- The ACA: Expanding Coverage, Protecting People with Health Care Needs
- Health System Upheaval and Workers Put at Risk: Consequences of Overturning and Undermining the ACA
- Texas v. Azar: ACA "Repeal" without "Replace"
- Preventive Services without Cost-Sharing
- Pre-Existing Condition Exclusions
- Dependent Coverage to Age 26
- Annual Out-Of-Pocket Limit
- Prohibition on Annual and Lifetime Limits
- External Review
- Administrative Actions to Roll Back ACA Result in Higher Prices for Older, Sicker Americans
- Conclusion
- Testimony of Chad Riedy, Resident, Alexandria, Virginia
- Testimony of Grace-Marie Turner, President, Galen Institute
- Employer-Sponsored Health Insurance
- ESI Supports Public Programs
- Costs and Coverage
- Association Health Plans
- Health Reimbursement Arrangements
- New Section 1332 Guidelines
- Protection for the Vulnerable
- State Solutions
- Testimony of Rahul Gupta, Senior Vice President and Chief Medical and Health Officer, March of Dimes
- Pre-Existing Conditions are Common among Women of Childbearing Age
- The Affordable Care Act Instituted Important Protections for People with Pre-Existing Conditions
- Pre-Existing Conditions Protections Alone Are Not Enough
- Any Changes to the Law Should Ensure Greater Access to Comprehensive, Affordable Care
- Conclusion
- At Risk: Stories from the Community
- Overturning Pre-Existing Condition Protections would Disproportionately Harm Racial and Ethnic Minorities
- Chapter 2
- Strengthening Our Healthcare System: Legislation to Reverse ACA Sabotage and Ensure Preexisting Conditions(
- Opening Statement of Hon. Anna G. Eshoo, a Representative in Congress from the State of California
- Prepared Statement of Hon. Anna G. Eshoo
- Opening Statement of Hon. Michael C. Burgess, a Representative in Congress from the State of Texas
- Prepared Statement of Hon. Michael C. Burgess
- Opening Statement of Hon. Frank Pallone, Jr., a Representative in Congress from the State of New Jersey
- Prepared Statement of Hon. Frank Pallone, Jr.
- Opening Statement of Hon. Greg Walden, a Representative in Congress from the State of Oregon
- Prepared Statement of Hon. Greg Walden
- Statements of Katie Keith, Associate Research Professor and Adjunct Professor of Law, Georgetown University
- Jessica K. Altman, Commissioner, Pennsylvania Insurance Department
- Grace-Marie Turner, President, Galen Institute
- Statement of Katie Keith
- Testimony of Katie Keith, J.D., M.P.H., Associate Research Professor and Adjunct Professor of Law, Georgetown University
- Threats to Progress under the Affordable Care Act
- Promoting Expanded Access to Short-Term, Limited Duration Insurance
- New Rule Expands Access to STLDI and Undermines the ACA's Single Risk Pool
- Increased STLDI Enrollment in 2019
- Aggressive Marketing of STLDI and Consumer Confusion
- State Regulation of STLDI
- New Guidance on Section 1332 Waivers
- Cuts to ACA Marketing and Outreach
- Conclusion
- Statement of Jessica K. Altman
- Testimony before the House Energy and Commerce Committee Subcommittee on Health, February 13, 2019
- Benefit Limitations
- Consumer Disclosure
- Post-Claims Underwriting and Claims Practices
- Ramifications for the Health Insurance Market
- The Pennsylvania Insurance Department's Approach to STLDI
- Conclusion
- Statement of Grace-Marie Turner
- Strengthening Our Health Care System: Legislation to Reverse ACA Sabotage and Ensure Pre-Existing Conditions Protections , Hearing before the Committee on Energy and Commerce, Chairwoman Anna G. Eshoo, Testimony by Grace-Marie Turner, President, Gale...
- New Section 1332 Guidelines
- Short-Term Limited Duration Plans
- Council of Economic Advisers
- Protection for Pre-Existing Conditions
- Navigators
- Appendix
- Association Health Plans
- Health Reimbursement Arrangements
- Section 1. Short-Term Limited Duration Insurance Rule Prohibition
- Section 1. Short Title
- Sec. 2. Providing That Certain Guidance Related to Waivers for State Innovation under the Patient Protection and Affordable Care Act Shall Have No Force or Effect
- Section 1. Short Title
- Sec. 2. Federal Exchange Outreach and Educational Activities
- Sec. 3. Determination of Budgetary Effects
- Section 1. Short Title
- Sec. 2. Requiring a Health Insurance Issuer Offering Short-Term Limited Duration Insurance to Include a Standardized Disclosure and Certain Information with Respect to Coverage Exclusions and Premium Variations in Marketing, Application, and Enrollmen...
- "Sec. 2730. Information Required to Be Included in Marketing, Application, and Enrollment Materials Distributed in Connection with Short-Term Limited Duration Insurance
- Limitation on Enrollment Period
- ADS for Short-Term Plans Lacking ACA Protections Swamped Consumers' Online Searches
- Changes in Short-Term Plan Rules
- 'Necessary Niche'
- Statement from the American Lung Association in Support of Legislation Repealing 1332 Guidance
- American Lung Association Opposes Short-Term Limited Duration Rule
- AHA/ASA Newsroom, Bill Would Reverse Administration Rule Allowing Short-Term Insurance Plans, American Heart Association Commends Introduction of H.R. 1010
- AHA/ASA Newsroom, Bill Would Overturn Guidance Permitting States to Undermine ACA Patient Protections
- Statement on "Strengthening Our Health Care System: Legislation to Reverse ACA Sabotage and Ensure Pre-Existing Conditions Protections, Submitted to the House Energy and Commerce Committee, Subcommittee on Health, February 13, 2019
- Ensuring Affordable, Comprehensive Health Coverage for All Americans
- Americans with Pre-Existing Conditions Should Be Protected
- Recent Regulatory and Administrative Actions
- Short-Term Plans
- Section 1332 Waivers
- Other Stability Measures
- Open Enrollment Outreach and Educational Activities
- Conclusion
- Concerns with New Guidance
- Concerns with Waiver Concepts Paper
- Additional Considerations for States
- Statement for the Record, Submitted to the House Committee on Energy & Commerce Health Subcommittee, Hearing on "Strengthening Our Health Care System: Legislation to Reverse ACA Sabotage and Ensure Pre-Existing Conditions Protections," February 13, 20...
- Overview
- AHPs Are Not the Same as Short-Term Health Plans
- AHPs Provide Comprehensive Coverage as Required under the ACA, ERISA, HIPAA, COBRA, and State Law
- Short-Term Health Plans Are Exempt from the ACA
- AHPs Are Subject to the ACA's Coverage Requirements
- Consumer Protections under ERISA, HIPAA, and COBRA Apply to AHPs
- The Proposed AHP Regulations Do Not Change the Requirements under ERISA, HIPAA, COBRA, and the ACA
- State Benefit Mandates Apply to Fully-Insured "Large Group" AHPs
- State MEWA Statutes Apply to Self-Insured AHPs
- The AHP Regulations Will Not Return the Health Care Markets to a "Pre-ACA World"
- AHPs Are the Same as Large Employer Plans
- Newly Created AHPs Are Offering Comprehensive Coverage
- A Regulatory Framework Has Been Put in Place over Time to Combat Fraud and Abuse
- Our Coalition Pledges to Work with the NAIC and Congress to Fight against Fraud and Abuse
- AHPs Will Not Segment the Markets
- Conclusion
- The Health 202: Association Health Plans Expanded under Trump Look Promising so far
- The Prognosis
- Health on the Hill
- Agency Alert
- Final Vote Results for Roll Call 69
- Subcommittee on Health, Hearing on "Strengthening Our Health Care System: Legislation to Reverse ACA Sabotage and Ensure Pre-Existing Conditions Protections," February 13, 2019
- Additional Questions for the Record, Ms. Katie Keith, JD, MPH, Associate Research Professor and Adjunct Professor of Law, Georgetown University
- The Honorable Debbie Dingell (D-MI)
- The Honorable Kathy Castor (D-FL)
- The Honorable Debbie Dingell (D-MI)
- The Honorable Kathy Castor (D-FL)
- About the Data
- Value of Bridge Plans
- Index
- Blank Page
- Blank Page
