header_insurancecarriers.jpgLast Wednesday, The Knowledge Group and Ceridian teamed up to present a Webinar: “Healthcare Reform and Its Impact on Carriers.” To present this special program I was pleased to join West Virginia Insurance Commissioner Jane Cline, DLA Piper partner Marcia Augusburger and Deloitte Consulting principal Bernard Tubiana.

While each of the panelists focused on a different aspect of healthcare reform and the Patient Protection & Affordable Care Act (PPACA), the presentations had a common theme: unprecedented uncertainty for carriers, employers, employees, states, health plans and brokers. Read more.

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Healthcare Reform Webinar: Uncertainty the Only Certainty (part 1)

Tue Feb 22, 2011

header_insurancecarriers.jpgLast Wednesday, The Knowledge Group and Ceridian teamed up to present a Webinar: “Healthcare Reform and Its Impact on Carriers.” To present this special program I was pleased to join West Virginia Insurance Commissioner Jane Cline, DLA Piper partner Marcia Augusburger and Deloitte Consulting principal Bernard Tubiana.

While each of the panelists focused on a different aspect of healthcare reform and the Patient Protection & Affordable Care Act (PPACA), the presentations had a common theme: unprecedented uncertainty for carriers, employers, employees, states, health plans and brokers.

Key points:

  • Commissioner Cline discussed a number of key issues important to insurance carriers, including Medical Loss Ratios (not lower than 85% of total premium revenue for large group plans), the rule on “unreasonable” rate increases to encourage transparency and the efforts of the National Association of Insurance Carriers.
  • Ms. Augusburger outlined certain insurance reforms likely to increase health benefits costs, including the ban on pre-existing condition exclusions and lifetime coverage limits, the phase-out of annual coverage limits and the requirement that plans offer coverage to adult children up to age 26. The DLA Piper executive then addressed the issue of the PPACA mandate that all individuals carry health insurance effective in 2014. Ms. Augusburger described the recent federal court decisions declaring the individual mandate unconstitutional, explaining legal arguments about the Constitution’s “Commerce Clause” and the “Taxing Power” of the U.S. government. Attendees were informed that ultimately the question will be decided by the Supreme Court of the U.S., perhaps within the next two years.
  • Mr. Tubiana’s presentation covered healthcare reform’s impacts beyond health plans, including on employees, employers, brokers and group, voluntary and worksite carriers. Employees are likely to see a number of benefits of PPACA, e.g., the prohibition on pre-existing condition exclusions and auto enrollment. Employers, on the other hand, will face new pressures on health benefit costs, the employer mandate and various group health plan requirements. While the individual mandate, if upheld, could bring an estimated 30 million individuals into the insurance market according to Mr. Tubiana, new state-based health insurance exchanges will pose a challenge to brokers, as could the trend toward standardization of health plans. As far as group, voluntary and worksite carriers are concerned, the Deloitte Consulting principal concluded that they would not be directly affected by PPACA but could be impacted by how employers, brokers, health plans and others react to the new law.

Later this week, I’ll dive into my presentation, “Political Change and Healthcare Reform: What to Expect in 2011.”