WASHINGTON Nov 20 President Barack Obama's
administration on Tuesday formally proposed new rules requiring
insurers to cover people with preexisting conditions and set
minimum health benefits to millions of others under U.S.
healthcare reform law.
Two weeks after Obama's re-election ensured the survival of
the 2010 law that Republicans have vowed to repeal, the proposal
is the first in an expected deluge of rulemaking to implement
the law in time for its Jan. 1, 2014, start date.
Defining essential benefits, guaranteeing sick people access
to coverage and promoting healthy living are well-known goals of
the Patient Protection and Affordable Care Act. But the proposed
rules set down in writing how each would be accomplished while
giving stakeholders and the public an opportunity for comment.
The benefits rule provides states and insurers guidance on
benefits and costs that must be covered through new state-based
online healthcare exchanges, and through small-group and
individual plans that are outside the exchanges but not
grandfathered under the law.
Taking aim at critics who say reforms amount to a rigid,
"one-size-fits-all" bureaucratic system, the Department of
Health and Human Services proposed giving states the discretion
to choose essential benefit benchmarks from typical private or
public plans already operating within their borders.
Health insurance companies would be prohibited from denying
coverage because of a pre-existing condition, or from charging
higher premiums because of current or past health problems,
gender, or occupation. The rules would ensure access to
catastrophic coverage plans for young adults and others who
could not afford coverage otherwise.
The administration also proposed a rule to expand
employment-based wellness programs to help control healthcare
spending and to protect individuals from unfair underwriting
practices that could otherwise reduce benefits based on their