Chiropractic Breakthrough

Kathleen Sebelius, the secretary of HHS, said Thursday that employers should immediately offer or continue health insurance coverage for workers’ children up to the age of 26, at little or no additional cost. At the request of the Obama administration, more than 65 insurers have already agreed to allow young adults to stay on their parents’ policies before the insurers are required to do so, under the new law, later this year or early next year.

The new health care law does not allocate nearly enough money to cover the estimated 5.6 million to 7 million Americans with pre-existing medical conditions who will qualify for temporary high-risk insurance pools. According to a report by the Center for Studying Health System Change the $5 billion earmarked for the pools might cover as few as 200,000 people a year.

A provision in the new health law allows adult children to stay on their parents’ health plans applies until they turn age 26. They don’t have to be full-time students, nor financially dependent on their parents. They can live out of state and have a job. If the adult child is offered health insurance on the job, he or she can no longer remain on the parents’ policy.

According to a report from the Commonwealth Fund, a private health policy foundation, most of the 13.7 million uninsured young adults could gain coverage in 2014 — either through public programs like Medicaid or by buying private policies on competitive insurance exchanges established by the new health care law.

According to a study of the new health care law by Mercer, 33% of employers with 50 or more employees may face tax penalties because they offer health insurance considered unaffordable to some employees. Coverage is deemed unaffordable if the workers’ share of premiums consumes more than 9.5% of their household income.

There are several ways that the new health law will trim Medicare over the next 10 years. A reduction in payments to the Medicare Advantage plans that about a quarter of Medicare beneficiaries belong to will mean a savings of $136 billion over 10 years. Some plans will likely shut down entirely, while others may no longer offer some of the extras, like gym memberships or vision and dental coverage.

The number of states jointly suing to overturn the new health care reform law on constitutional grounds swelled to 20 last week. It is the latest reminder that politicians will continue to posture and demagogue the issue through the November elections and beyond.

Coca-Cola, PepsiCo, and the soda industry, are trying to defeat a soda tax now before the District of Columbia Council. The industry has succeeded recently in beating back similar taxes in NY and PA and in keeping one out of the federal health overhaul bill. Washington Council members are set to vote on the issue next week.

Starting in 2014, insurers will be required to offer a clearly defined package of essential health benefits. Consumers will be able to choose from four different levels of color-coded coverage — platinum (which will pay 90% of the cost of services), gold (80%), silver (70%) or bronze (60%). Young adults can opt for even less coverage. Policies will be priced accordingly.

Health insurance companies are lobbying federal and state officials in an effort to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care.