Pre-existing condition rule released

Nov. 20, 2012 at 2:12 PM

WASHINGTON, Nov. 20 (UPI) -- The U.S. Health and Human Services Department released new rules Tuesday requiring health insurance companies to cover people with pre-existing conditions.

Besides implementing provisions that would make it illegal, beginning in 2014, for insurance companies to discriminate against people with pre-existing or chronic conditions, the new regulations for the Affordable Care Act would make it easier for consumers to compare health plans and employers to promote and encourage employee wellness, the department said in a release.

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

Labor Secretary Hilda Solis said the healthcare law recognizes that "well-run, equitable workplace wellness programs allow workers to access services that can help them and their families lead healthier lives," which benefit employers because of reduced costs associated with a healthier workforce.

The rule barring discrimination because of a pre-existing or chronic condition would allow insurance companies to vary premiums, within limits, only based on age, tobacco use, family size and geography. The rule prohibits insurers from varying premiums based on other factors, such as gender, health status or occupation.

The rule would ensure that young adults and people for whom coverage would otherwise be unaffordable have access to a catastrophic coverage plan in the individual market.

Another rule released Tuesday is intended to define more clearly "essential benefits" that insurance plans must cover beginning in 2014. Essential health benefits are a core set of benefits that would give consumers "a consistent way to compare health plans in the individual and small group markets," the department said.

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