WASHINGTON — Most health insurance plans will soon be barred from turning children down due to pre-existing medical problems, under an enforcement plan the White House announced Tuesday for the new patients' bill of rights.
President Barack Obama is marking the first 90 days since he signed the landmark health care overhaul legislation by spelling out details of how the law's short-term benefits will be implemented. The major expansion of coverage to some 32 million now uninsured doesn't come until 2014, but other safeguards take effect for plans renewing on or after Sept. 23.
In addition to guaranteed coverage for children, the safeguards include:
— A ban on lifetime coverage limits. More than 100 million people are enrolled in plans that currently impose such limits, the White House said.
— Phasing out annual coverage limits. Starting this year, plans can set annual limits no lower than $750,000. Such limits rise to $2 million in 2012, and will be completely prohibited in 2014.
— Forbidding insurers from canceling the policies of people who get sick. Unintentional mistakes on application forms cannot be used to revoke a policy.
— Guaranteed choice of primary care doctors and pediatricians from a plan's network. No referral needed for women to see an ob-gyn specialist. No prior approval needed to seek emergency care out-of-network.
The new rules apply to most health plans, except in cases where they are “grandfathered” under the law.
The White House announcement comes as administration officials meet privately with state insurance commissioners, and CEOs of major insurance companies, amid concerns over continued premium hikes. Obama was expected to attend at least part of the session, and is scheduled to make a speech later.
Consumers who buy their policies directly faced increases averaging 20 percent this year, according to a survey released Monday by the Kaiser Family Foundation. Although most Americans are covered on the job, about 14 million purchase insurance on the individual market and have the least bargaining power when it comes to costs.
It's still unclear how insurance companies will price the new guaranteed coverage for children. If premiums are too high, families may still be unable to get health insurance.
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