If Republicans want to campaign based upon promises to repeal “ObamaCare,” I wonder which parts of the recently unveiled Patients’ Bill of Rights they would like to repeal:
• No Pre-Existing Condition Exclusions for Children Under Age 19. Clarifies that health plans have to accept sick children before 2014 and cover all of a child’s illnesses if that child already had coverage. These protections will apply to all types of insurance except for individual policies that are “grandfathered,” and will be extended to Americans of all ages starting in 2014.
• No Arbitrary Rescissions of Insurance Coverage. Prohibits insurers and plans from rescinding coverage except in cases involving fraud or an intentional misrepresentation of material facts, not for unintentional mistakes. Insurers and plans seeking to rescind coverage must provide at least 30 days advance notice to give people time to appeal. There are no exceptions to this policy.
• No Lifetime Limits on Coverage. Prohibits the use of lifetime limits in all health plans and insurance policies issued or renewed on or after September 23. More than 100 million Americans currently have health coverage that imposes such lifetime limits.
• Restricted Annual Dollar Limits on Coverage. Phases out annual limits on how much employer plans and new individual health plans pay for health care and bans limits on essential health benefits by 2014. For plan years starting on or after Sept. 23, insurers will be allowed to set annual limits no lower than $750,000; on Sept. 23, 2011, the limit rises to $1.25 million; and on Sept. 23, 2012, it increases to $2 million. Employers and insurers can ask for a delay if they can demonstrate that their current annual limits are necessary to prevent a significant loss of coverage or increase in premiums.
• Doctor Choice. The new rules make clear that health plan members are free to designate any available participating primary care provider as their provider. The rules allow parents to choose any available participating pediatrician to be their children’s primary care provider. They also prohibit insurers and employer plans from requiring a referral for obstetrical or gynecological (OB-GYN) care. These policies apply to all individual market and group health insurance plans except those that are grandfathered.
• Removing Insurance Company Barriers to Emergency Department Services. Prohibits health plans and insurers from charging higher cost-sharing (co-payments or co-insurance) for emergency services that are obtained out of a plan’s network. The rules also set requirements on how health plans should reimburse out-of-network providers. This policy applies to all individual market and group health plans except those that are grandfathered.
More information on the Patients’ Bill of Rights is contained in this Fact Sheet. It looks like Obama’s new slogan will be Yes We Did and the Republicans will have to hope people continue to believe their distortions of health care reform and other Democratic policies.