Expanded health insurance rules take effect nationwide

Posted Sept. 23, 2010, at 11:23 p.m.

ORONO, Maine — From now on, young adults are covered by their parents’ health policies up until their 26th birthday. Children with pre-existing health conditions cannot be denied insurance. And coverage for preventive screenings such as mammogram and colonoscopy must be covered at 100 percent, without being subject to out-of-pocket co-payment or deductible requirements.

Thursday marked a milestone in national health reform, with several consumer protection provisions taking effect. Champions of the Obama administration’s Affordable Care Act gathered at the University of Maine to highlight the new provisions.

Tim McGuire, a recent graduate of Husson University and a member of the Maine People’s Alliance advocacy organization, said he is relieved to be able to retain his health care coverage through his parents’ policy.

McGuire, who falls into an age category referred to in insurance circles as “the young invincibles” because they often choose to forgo insurance coverage, said the new requirement is a lifesaver for young adults who have previously relied on “the don’t-get-sick plan.” Now, instead of either going uninsured or else feeling pressured to find a job that provides affordable insurance coverage, he said, young Americans will be able to work at jobs that truly interest them, even if the benefits are poor.

Reps. Emily Cain, D-Orono, and Adam Goode, D-Bangor, pointed out that other provisions of the national reform already have taken effect, including small-business tax credits for employers that offer insurance to their workers and $250 rebates to senior citizens who fall into the Medicare Part D gap in prescription drug cover-age.

Maine already provides many of the consumer protections afforded by the national health reform, Cain said, but the state still must prepare to take advantage of financial and regulatory changes ahead, including the formation of a health insurance marketplace to help Mainers make informed choices about their coverage. And provisions such as extending parental policy coverage to age 26 for their children will provide coverage for an additional 3,300 young Mainers, according to the Public Interest Research Group.

Goode and Cain both serve on a special legislative committee charged with overseeing the implementation of the national reform in Maine.

Greg White of the advocacy group Consumers for Affordable Health Care pointed out that many of the provisions of the health reform, including the insurance exchanges and a requirement that all Americans have some kind of health coverage, won’t take effect until 2014.

“We haven’t seen the full benefit of this bill yet,” he said.

Katie Dunton, a spokeswoman for the Maine Bureau of Insurance, said the insurance changes announced Thursday are complex and will vary from person to person and policy to policy. For example, she said, in most cases parents will not be able to add an adult child to their existing employer-based coverage until the policy’s annual open enrollment period. The new preventive screening benefits do not apply to some policies, she said, including those that have been “grandfathered” under the law.

Dunton recommended that Mainers call the insurance bureau’s consumer division at 800-300-5000 and ask for information on the health care reform.

“Every situation is different,” she said. “We will do our best to answer all your questions, but sometimes we will need to look things up and get back to you.”

With many of the provisions not taking effect until 2014, Republicans have vowed to repeal parts of the law should they assume control of Congress after the November elections.

Consumer-friendly information also is available on the website of the Bureau of Insurance.

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