Obama Administration Releases Draft Rules On Preexisting Conditions

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The Department of Health and Human Services released draft rules Tuesday regarding the implementation of a critical piece of the Affordable Care Act — the ban on insurer practice of denying coverage to people with preexisting conditions.

In an advisory, HHS described the rule, which is not yet final:

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, only based 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.

HHS also issued draft regulations on the types of “essential health benefits” that insurance plans must include, alongside other insurance market reforms.

“The Affordable Care Act is building a health insurance market that works for consumers,” said HHS Secretary Kathleen Sebelius. “Thanks to the health care law, no one will be discriminated against because of a pre-existing condition.”

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