HHS releases insurance rules


On Tuesday, November 20 the Department of Health and Human Services released regulations outlining essential health benefits, pre-existing condition rules, and expanding employment-based wellness programs. All three regulations implement parts of the Affordable Care Act (ACA). Under the proposed rule governing essential health benefits, individual and small group plans available in health insurance exchanges will have to meet benchmark standards for price and coverage in ten health benefit categories. The benchmarks in each state or territory will be established under a complex scheme comparing plans available to large employers, state employees, and federal employees. Many rural advocates have long awaited this rule with hopes that insurance coverage parody would be accomplished through this provision of the ACA. According to a 2011 report by the Department of Health and Human Services, rural Americans are much less likely to be covered by an employer's insurance policy or have any health insurance at all. The pre-existing condition and employment-based wellness program rules include incentives to individuals and insurers. While the ACA forbids insurers from denying coverage for pre-existing conditions, the law and regulations announced today allow insurersĀ increased financial leverage to incentivize healthy behavior, especially not smoking. For more news coverage on the release of these rules, click here. For the federal government's regulatory clearinghouse, click here.

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