Obamacare Facts #4-#6


4) PREVENTIVE MANDATE CONTROVERSIES TO COME – Health insurers must cover vaccinations, preventive care and screening for children, and services with an ‘A’ or ‘B’ rating from the U.S. Preventive Services Task Force, the committee that issued the 2009 recommendation to limit mammography. To address the ensuing controversy, the law specifies, “for the purposes of this Act, and for the purposes of any other provision of law, the current recommendations of the U.S. Preventive Service Task Force regarding breast cancer screening, mammography, and prevention shall be considered the most current other than those issued in or around November 2009.” [Emphasis added.] (Sec. 1001 of the ACA, which amends Sec. 2713 (a) of title XXVII of the Public Health Service Act)

5) INSURERS ALLOWED TO ERECT BARRIERS TO CARE – The federal government is authorized to “develop guidelines to permit…[insurers] to utilize value-base insurance designs” (VBID). In December 2010, public comments were requested in connection with VBID for preventive care benefits. The National Conference of State Legislatures describes VBID as “using financial incentives to promote cost efficient health care services…” Oregon’s VBID for public employees, per NCSL: “Cost-sharing is higher for health services that are nationally recognized as overused and driven by provider preference or supply rather than evidence-based need…” (Sec. 1001 of the ACA, which amends Sec. 2713(c) of title XXVII of the Public Health Service Act)


6) AGE 26 REQUIREMENT RAISES COSTS; ENDS CHEAPER CHOICES  - Insurers “shall continue to make [dependent coverage of children] available for an adult child until the child turns 26 years of age” but the insurer need not cover a child of the adult child. In September 2010, most health insurers dropped their inexpensive child-only policies (insurer exits in 39 states, per Senate HELP Committee, 8/2/11), impacting as many as 500,000 children. Parents of adult children face increased costs of 0.7% in 2011 and 1.0% each year in 2012 and 2013, per federal officials. Coverage cost about $3,690 per child in 2013. (Sec. 1001 of the ACA, which amends Sec. 2714 of title XXVII of the Public Health Service Act)