Administration Issues Proposed Rules Implementing the ACA

The Obama administration issued a proposed rule that, beginning in 2014, prohibits health insurance companies from discriminating against individuals because of a pre-existing or chronic condition. Under the rule, insurance companies would be allowed to vary premiums within limits,  based only on age, tobacco use, family size, and geography. Health insurance companies would be prohibited from denying coverage to any American because of a pre-existing condition or from charging higher premiums to certain enrollees because of their current or past health problems, gender, occupation, and small employer size or industry. The rule would ensure that people for whom coverage would otherwise be unaffordable and young adults have access to a catastrophic coverage plan in the individual market. For more information regarding this rule, visithttp://www.healthcare.gov/news/factsheets/2012/11/market-reforms11202012a.html.

The administration also issued proposed rule outlining policies and standards for coverage of essential health benefits while giving states more flexibility to implement the Affordable Care Act. Essential health benefits make up a core set of benefits that would give consumers a consistent way to compare health plans in the individual and small group markets. A companion letter on the flexibility in implementing the essential health benefits in Medicaid was also sent to states. For more information regarding this rule, visit http://www.healthcare.gov/news/factsheets/2012/11/ehb11202012a.html.

In addition, the administration issued a proposed rule implementing and expanding employment-based wellness programs to promote health and help control health care spending while ensuring that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status. For more information regarding this rule, visithttp://www.healthcare.gov/news/factsheets/2012/11/wellness11202012a.html.

Last Updated 7/11/2017

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