Friday, October 1, 2010

The Patient and Protection Affordable Care Act…..6 months later

While The Patient and Protection Affordable Care Act (ACA) was enacted on March 23, 2010, it didn’t officially go into effect until last week on September 23. However, despite being enacted, there are still many debates and discussions raging on about the bill.

The goal of the ACA was to reduce the cost of healthcare, improve the quality of care and improve the overall member experience. Thus ACA included the following items:
  • No lifetime or restricted annual limits on benefits
  • Eliminated pre-existing conditions and rescissions
  • Young adults covered to age 26 on their parent's policy
  • Drug discounts for seniors (starting June 15, 2010)
  • Tax break for small businesses
However, there are also additional changes taking place behind the scenes that many consumers are unaware of, but could greatly alter the healthcare landscape. Most notably, changes to Medicare Enrollment Period’s and Medical Loss Ratio calculations.

With reduced enrollment periods, plans will have to alter how and when they market to their members. This constricting timeline is going to make an already trying process, an even greater strain on resources. Additionally, the 80-85% Medical Loss Ratio that plans will be mandated to operate at will force some plans to change their plan type, or worse may force them to drop certain coverage in order to comply.

On top of all of this, with November elections looming, funding may be reduced or cut and each new member of Congress will push for what they think will be the best circumstance for their delegates. Like always, Merrill Corporation will be monitoring all these changes and more from HHS, CMS and all other regulatory bodies to ensure that health plans can successfully navigate and comply with Health Reform.

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