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Health Care Reform – Insuring Children with Preexisting Conditions

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One of the first components of the health care bill to take effect is the requirement that insurance companies provide coverage for children under age 19 who have preexisting conditions.

The change is slated to take place in September of 2010 and is designed to prevent children from being excluded from their parent’s policy or a similar stand alone policy that can be purchased in the open market.

No Exclusions for Children

After September, health insurance companies will no longer be able to exclude children with preexisting conditions from coverage. Additionally, they cannot place a rider or exclusion on any conditions which would trigger a waiting period for coverage to begin.  The simply means that health insurance carriers will have to insure all children regardless of their past health history.

Health Insurance Premiums for Children

It is still somewhat unclear how these legislative changes will affect premiums.  The intent of the new law is to put a cap on premiums that can be charged by the insurance carriers and to close any loopholes which could result in a child being denied coverage.  Working through the NAIC, insurance providers have said they will cooperate with the federal government and operate within the confines and intent of the law.

Overall, this is good news for children who have had difficulty enrolling in a comprehensive health insurance plan. How these changes may play out as part of the health care overhaul in total is yet to be told. It is the opinion of this insurance representative should health care reform be repealed or overhauled, guaranteed coverage for children is one area politicians are unlikely to change.

Adults with Preexisting Conditions

Adults with similar problems finding insurance will have to wait longer. As it stands now, adults with preexisting conditions will have to wait until 2013 before insurance companies will be required to cover said conditions or provide coverage at all.

Legislative changes could happen between now and then, but states are moving quickly to create high risk health pools to accommodate those who are currently uninsurable.  (It should be noted that high risk pools exist in many states already.)

State run programs for high risk individuals should be up and running within the next six months across the U.S. They will be subsidized by the federal government and will have caps on the monthly premiums which can be charged.

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Category: Health Care Reform