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Reforms in Health Insurance

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HEALTH INSURANCE REFORM AT A GLANCE

INSURANCE MARKET REFORMS THAT PROTECT CONSUMERS
The Senate passed bill as improved by reconciliation will improve the health insurance marketplace by strengthening consumer protections and providing consumers with the information they need to choose the best health care coverage for their families.

NO DISCRIMINATION FOR PRE-EXISTING CONDITIONS, GENDER OR OTHER CHARACTERISTICS
Insurers and health plans will be prohibited from denying individuals health insurance coverage due to a pre‐existing condition and from charging individuals with pre‐existing conditions higher premiums or excluding coverage for specific conditions. Insurers and health plans selling to individuals and small businesses will be prohibited from charging higher premiums due to gender, health status, family history, or occupation. Limits will be placed on how much premiums may vary based on age (3:1) or tobacco use (1:1.5) on insurers selling to individuals and small businesses. Because these changes are dependent upon all Americans having access to quality, affordable health insurance, they take effect when the Exchanges are operational in 2014.

NO PRE-EXISTING COVERAGE EXCLUSIONS FOR CHILDREN
Recognizing the special vulnerability of children, all health plans will be prohibited from excluding coverage of pre‐ existing conditions for children, effective six months after enactment and applies to all plans.

EXTENSION OF DEPENDENT COVERAGE FOR YOUNG ADULTS
Insurers and health plans will be required to permit adult children to stay on family policies until age 26. This provision takes effect six months after enactment and applies to all plans.

REQUIRED COVERAGE FOR PREVENTIVE CARE WITH NO COST-SHARING
Insurers and health plans will be required to offer and provide first dollar coverage of preventive health care services....

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