Access to Health Insurance
Download this set of FAQs> (PDF: 90K)
How does the health care bill reform health insurance markets?
A: The Acts’ health insurance provisions reform the nation’s currently dysfunctional individual and small group health insurance markets. They do so by:
The Exchanges and SHOP will be "one-stop shops" for finding out what policies are available in a given community, comparing different policies and purchasing both private individual and small business insurance products. The Exchange and SHOP will be open to any insurer who offers a product that meets and abides by the underwriting and rating (i.e. pricing) rules set out by the legislation.
- Creating a mechanism – Exchanges for individuals and SHOP for small employers - to create larger insurance pools and simplify the onerous task of shopping for the best insurance policy, whether you’re an individual, a family or an employer; and
- Replacing the existing set of 50 different state laws governing health insurance with a uniform set of more consumer-protective underwriting and rating rules.
In addition, the legislation spells out new underwriting and rating rules policies that would be more consumer-protective than is currently the case under state law. These new rules would be on par with what most people think of when they hear the term "group policy".
Q: Could I be denied coverage under the new rules?
A: No. The Acts’ underwriting standards require all policies be "guaranteed issue." Insurers cannot turn anyone down for reasons related to pre-existing conditions, current health status, previous claims, age, type of employment, etc.
Q. Could my insurer decide to not renew my policy?
A: No. The Acts guarantee that your insurance provider must renew any policy that it has issued and for which you have paid.
Q: Can an insurer rescind or cancel my insurance policy?
A: No.The Acts ban policy rescissions or cancelations without good cause, i.e. failure to pay premiums associated with a policy, fraud, etc. Health status or health claims are not a basis for cancelation or rescission.
Q: Would there be waiting periods to receive insurance coverage?
A: No. The Acts limit the length of any waiting period to 90 days. In many cases, there will be no waiting period.
Q: How will pre-existing conditions be handled?
A: The Acts bar the use of pre-existing conditions as an underwriting factor, so no one can be rejected because of those conditions. Moreover, pre-existing conditions may not be used as a factor in setting premium prices.
Q: How will premiums be determined?
A:The Acts reduces the number of factors that insurers can use to determine premium costs:
- Age (How old is the insured?),
- Location/geography (Where does the insured live?),
- Type of policy (What plan is the insured purchasing —individual,couple, parent/child, or family?), and
- Coverage level (How high are the plan’s deductibles? How comprehensive is the plan's coverage?)
New Medicare Tax on "UNEARNED" Net Investment Income
New Medicare Tax on EARNED INCOME: Wages, Salaries and Commissions
The Final Legislation
Need for Reform — A REALTOR® Perspective
Health Insurance Exchange and SHOP
If You Already Have or Provide Coverage
Paying for Health Reform
NAR Advocacy Positions
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NAR Takes Action