- Budget deal to get quick vote in the House
- Comma on!: Twitter erupts over Obama-Castro ‘marriage’
- Sebelius calls for review of Obamacare rollout woes
- American dream dying, but many see free market as solution: Poll
- Air Force base in South Carolina boots Nativity scene
- Israel poised for a $173M boost from the U.S. for missile defense
- Leon Panetta named as source of ‘Zero Dark Thirty’ scriptwriter’s information
- Mandela service sign language interpreter: ‘He made up his own signs’
- Pope Francis named Time’s ‘Person of the Year’
- Ben Affleck: Fundraising for Democrats started to ‘feel gross’
Health law directives strengthen coverage for drugs
Rules will guide new exchanges
The Obama administration has strengthened the prescription drug coverage that will be available to the millions of people who will get insurance through the nation's new health care overhaul starting late next year.
The increase in prescription benefits was part of a long-awaited package of law-implementing rules announced Tuesday by the Health and Human Services Department. The government laid out minimum requirements for health insurance coverage and banned denying coverage to people with pre-existing health problems.
The new rules, once made final, will govern the operation of new health insurance marketplaces, called exchanges, that will debut in 2014.
Having the federal government set minimum standards for what health insurance must cover is a departure from normal practice. Usually, insurance companies, state regulators and employers play that role. But the Affordable Care Act requires that Washington establish a baseline for minimum coverage in areas that include inpatient and outpatient care, emergency services, maternity and childhood care, prescription drugs, preventive screenings and lab work.
It must also cover mental health and substance abuse treatment, as well as rehabilitation for physical and cognitive disorders, and dental and vision care for children. Such additional benefits are often not fully covered by plans that are now the best that many small businesses can afford.
Many of the details the administration released Tuesday had been previously announced, but Dan Mendelson, CEO of the market analysis firm Avalere Health, saw one key change: Health insurance plans will now have to cover the same number of prescription drugs as the benchmark plan in their states. That basically means there will be a higher number of prescription drugs covered in each class, such as antipsychotics or antidepressants, than had previously been required.
"It's going to dramatically increase access to pharmaceuticals in the exchanges," Mr. Mendelson said. "It's a big deal. This makes the exchange offerings more consistent with what employers offer."
The administration also laid out more details behind previously announced rules that govern how insurers cover people. The rules prevent insurers from denying coverage to someone because he has a pre-existing or chronic condition, and they also limit how much insurers can vary premiums by age.
Starting in 2014, the overhaul will expand coverage to millions of people in part by offering tax credits that help them buy coverage on the exchanges. Enrollment for plans sold on the exchanges will start next October, and HHS officials said Tuesday they were confident the exchanges and the coverage sold on them will be ready.
The latest update from the administration seems to be keeping "with the spirit of providing comprehensive benefits at an affordable price," said Neil Trautwein, a vice president of the National Retail Federation, a business group whose members will be heavily affected by the law.
"Of course, the proof is in the price tag of the policy," he said, noting that it's still unclear how the required benefits will affect premiums.
HHS and the Labor Department issued the proposed rules and will take feedback or comments on them for the next 30 days. After that, the government will issue the final rules.
By Donald Lambro
Growth spikes are little more than trend-free anomalies
- Teen thugs in DC run wild -- even while wearing GPS ankle bracelets
- New budget accord saves $23 billion -- after $65 billion spending spree
- Obama takes 'selfie' at Mandela's funeral service
- VEGAS RULES: Harry Reid pushed feds to change ruling for casino's big-money foreigners
- CARSON: Why did the founders give us the Second Amendment?
- More than a quarter million sign up for Obamacare in November
- Gov't Motors: Obama fudges math on auto bailout, $10.5 billion loss for taxpayers
- MILLER: Dick Heller challenges D.C.s gun registration, files for summary judgement in Heller II
- Obama's antics at Nelson Mandela tribute: Jovial conversation, handshake with Raul Castro
- Somber duty: U.S. presidents in hot demand at Mandela's memorial
Independent voices from the The Washington Times Communities
All of the world’s problems, solved on your back porch
Human interest stories to feed interest, satisfy curiosity and see outside the box.
Politics, economics, and business from a real world perspective.
News and views on the Civil War.
White House pets gone wild!
Let it snow