Insurers to keep popular coverage items from health reform even if court strikes law down

Insurers to keep popular coverage items from health reform even if court strikes law down

June 12th, 2012 by Associated Press and Staff Report in Local - Breaking News

Some of the nation's biggest health insurers, including the biggest health plans in Tennessee, will keep some popular parts of President Barack Obama's health care overhaul even if the law fails to survive Supreme Court scrutiny later this month.

UnitedHealth Group, Humana, Aetna and BlueCross BlueShield of Tennessee all said Monday that they will continue to cover preventive care such as immunizations and screenings without requiring patients to pay a set fee called a co-payment.

They also said they'd still cover adult children up to age 26 through their parents' insurance plans.

Additionally, they all pledged to continue to offer a simple process for patients who want to appeal when their health insurance claims have been denied.

Mary Danielson, a spokesman for BlueCross in Tennessee, said many of the features required of plans under the health care reform law adopted by Congress two years "are all important elements in making sure people get the access to care they need." In addition to keeping coverage for preventive care and dependents up to age 26, BlueCross in Tennessee also said it won't reinstate lifetime limits on most coverage.

"We've long advocated the need for reform and these are provisions that are desired by our members," she said.

WellPoint, the nation's second largest insurer behind UnitedHealth, said it will announce its plans after the Supreme Court's ruling. The company runs Blue Cross Blue Shield plans in Georgia and a dozen other states.

Challenges from states and other groups opposed to the law, which was passed in 2010, made their way to the Supreme Court. Justices are expected to rule later this month on whether to uphold the law or strike down parts or all of it.

That major insurers are keeping some of the early provisions of the law underscores the popularity of those requirements. Patients have already gotten used to the benefits, and the insurers have already factored the cost of the provisions into the premiums that customers have to pay for coverage.

Bob Laszewski, a consultant in the insurance industry, said insurers have probably added about 3 percent to a patient's bill for the early provisions, depending on the type of coverage. As a result, he said it makes sense for insurers to keep the early provisions because if they didn't, customers probably would expect a corresponding drop in the premiums they have to pay.

"It would probably be more trouble to roll these things back than go ahead with them," said Laszewski, a former insurance executive. "It just makes common sense to leave these things in there and not take these benefits away since they're already priced in

UnitedHealth Group Inc. and Humana Inc., the nation's No. 5 insurer, went further than No. 3 Aetna Inc. by saying they'd keep several early provisions of the law.

Both companies said they won't impose lifetime dollar limits on how much an insurance policy pays out to cover claims. That helps people fighting cancer and expensive, chronic illnesses. The two insurers also both said they would not pursue rescissions, or the cancellation of a person's coverage retroactively, except in limited instances such as cases of fraud.

Both companies said in separate statements Monday that they decided to keep the provisions because they make sense. Humana said that its customers should "have the peace of mind" knowing that the company will keep the provisions even if the law isn't upheld.

"The protections we are voluntarily extending are good for people's health, promote broader access to quality care and contribute to helping control rising health care costs," UnitedHealth CEO Stephen J. Hemsley said.

Still, the insurers stopped short of promising to extend an important initial overhaul provision that requires the coverage of children up to age 19 with pre-existing conditions. This gives children with expensive medical conditions a chance to land some sort of insurance coverage on the individual market to help pay bills.