Much of the healthcare community is eager to hear what the Supreme Court has to say – likely next week – about the ACA. Given how polarized the topic of healthcare reform has been over the past few years, there’s no way that any decision is going to please more than about half of the country, although the court has the option of picking and choosing various parts of the law to uphold or overturn as it sees fit.
Some aspects of the ACA have already been implemented and have proven to be very popular. A few of the country’s biggest health insurance carriers have stated that they will keep some of the most popular ACA provisions – even if the law is overturned. Aetna, Humana, and UnitedHealth have said that they will continue to offer preventive care with no cost-sharing, allow young adults to remain on their parents’ health insurance policy through age 26, and maintain the third-party appeals process that insureds can use if a claim is denied. Humana and UnitedHealth have also said that they will continue to have no lifetime benefit maximums on their policies and ban rescission except in cases of fraud.
Of course, just because a health insurance carrier offers a particular benefit doesn’t mean that an employer has to utilize that feature if it’s not required by law. So it’s unclear how much of an impact these benefits would have if they were offered but not mandatory. In addition, there are concerns about the costs and tax implications of some of the benefits, like allowing grown children – who are no longer counted as dependents for tax purposes – to remain on their parents’ health insurance policy. In the case of that particular provision, even without the tax and cost issues, I have read several opinions from people who warn that keeping “children” on their parents’ health insurance policy through the age of 26 is fostering a dysfunctional state of dependence. I can see that one from both sides, but I think that the provision to allow young adults to remain on their parents’ health insurance policy is particularly beneficial for people with pre-existing conditions who are unable to obtain health insurance in the individual market. The ACA did help mitigate that problem via the high risk pools (prior to the ACA, not all states had high risk pools, and people in those states who had significant pre-existing conditions and no access to group coverage were out of luck as far as health insurance was concerned). But it does seem wise to at least give families the option to choose whether or not to keep young adults on the family health insurance policy for a few years after they’ve finished school. For some families, the cost might be worth it. Prior to the ACA, this wasn’t an option at all, so it’s good to see that some of the country’s largest health insurance carriers are committed to keeping the option in place.
Aetna no longer offers individual health insurance policies in Colorado, but Humana and UnitedHealth (Golden Rule) are quite popular in the individual market here. The ACA provisions discussed above currently apply to group and individual policies.