Expert Perspective UPDATE by Robert Cirkiel of UHY and a member of Grahall’s Editorial Board
Wednesday May 26, 2010
Robert Cirkiel writes: “Since publishing the blog Health Care Reform Redux (below), “interim final regulations” have been issued regarding the age 26 dependent coverage requirement. These are not proposed regulations, and the “interim final” tag means that they are final but the agencies are accepting comments.
If you think this means that comments will have no impact and therefore commenting is a waste of time I can’t disagree.
Regardless, my actuarial group will be issuing a comment letter nonetheless, as we believe we have uncovered a number of potential “unintended consequences”. Also, if the use of “interim final” is a portent of things to come, it means that the time honored process of issuing regs in proposed form that are subject to change may be curtailed. Stay tuned.”
Expert Perspective by Grahall’s Editorial Board
Monday May 24, 2010
In his May 15, 2010 New York Times article Health Insurance Companies Try to Shape Rules author Robert Pears writes: “Health insurance companies are lobbying federal and state officials in an effort to ward off strict regulation of premiums and profits under the new health care law. The effort is, in some ways, a continuation of the battle over health care that consumed Congress last year. Insurance lobbyists are trying to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care… The health care overhaul provides a classic example of how the impact of a law depends on regulations needed to interpret it.”
Weighing in at over 900 pages in length, the Patient Protection and Affordable Care Act provides little insight, however, into what employers, insurers and individuals must do to comply. (For a little “light reading” you can access the bill at http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf).
With such limited information and ambiguity in the bill, the regulations will be key to how both providers and users of healthcare are impacted. Regulators have a long way to go to get the regulations drafted. Even for those elements of the bill with 2010 effective dates , there has been nothing provided other than some narrow “guidance.” And like any other regulatory process, once regulations are drafted, comment periods, hearings and redrafting will follow, based on input from constituent groups. And lobbying will be part of this process.
Let’s take a closer look at the two areas that Health Insurance providers find so unpalatable: regulating premium increases and increasing medical loss ratio (MLR) requirements. What’s the problem with these two areas as far as Health Insurance companies are concerned?
Continue reading “UPDATE: Heath Care Reform Redux” »