I’m confused – Are we creating personal accountability in our health care system or not?!

In my opinion, the move toward consumer driven health care is long over due. Why shouldn’t consumers purchase health care utilizing the same economic cost benefit analysis used to purchase most other consumer goods and services? The successful evolution of consumer driven health care plans (those with super high deductibles coupled with health savings accounts) demonstrate to us that individuals are in fact willing to shop for health care utilizing a cost benefit analysis. More and more consumers are demanding to know the cost of services before purchasing and are studying that pricing data in light of available quality data in order to make more educated health care purchasing decisions. Consumer driven health care plans have been decades in the making. They are forcing a degree of personal accountability into the health care market place. So, if health care policy is moving toward empowering consumers to make health care decisions on their own with an eye on the economics of the situation, why is it that the Patient Protection and Affordable Care Act contains a provision requiring group health plans and insurers which offer dependant coverage of children to extend such coverage to dependants until they reach the age of 26? Believe it or not, the regulations issued last week addressing this provision of the Patient Protection and Affordable Care Act even goes so far as to call an individual under the age of 26 a “child.” In my opinion, forcing this increased dependency of our future generations does little to further the development of personal accountability for one’s health care and health care purchasing decisions. Nonetheless, since we are stuck with the mandate of dependant coverage through age 25, let’s examine the extent of these new regulations. For plan years beginning on or after September 23, 2010, group health plans and group health insurance issuers must offer dependent coverage through age 25 if any dependent coverage is offered as a part of the plan. The definition of “dependent” is left to group health plans and issuers offering coverage; however, the definition of dependent may not take into account: • the presence or absence of the child’s financial dependency upon the plan participant or any other person for that matter; • residency with the participant or any other person for that matter; • student status; • employment; or • any combination of the above factors. Yes, you have that correct. A 25 year old with a graduate degree who owns their own home, is newly married and financially independent will have the opportunity to remain on their parents’ health insurance until they reach the age of 26. If that isn’t enough to make you want to go “hmmm,” consider the fact that the newly implemented regulations also state that the terms of a group health plan or health insurance coverage providing dependent coverage of children “cannot vary based on age (except for children who are age 26 or older).” An example is included in the regulations in order to drive the point home. Here it is: “A group health plan offers a choice of self-only or family health coverage. Dependent coverage is provided under family health coverage for children of participants who have not attained age 26. The plan imposes an additional premium surcharge for children who are older than age 18.” “In the Example, the plan violates [the new requirement] because the plan varies the terms for dependent coverage of children based on age.” Lastly, the new regulations address the situation of those young adults who have lost coverage based upon the fact they were no longer a “dependent” under their parents health insurance. For those young adults who have lost coverage and who have not yet attained the age of 26, they must be given written notice (individually or through their parents) of the opportunity to re-enroll. The opportunity to re-enroll must last for a period of 30 days. Coverage must take effect no later than the first day of the first plan year beginning on or after September 23, 2010. The only special rule for the above described mandate involves a “grandfathered group health plan.” For grandfathered group health plans, dependent care coverage need not be offered to young adults under 26 if the young adult is eligible to enroll in an “eligible employer-sponsored health plan” other than a group health plan of a parent. I fail to see how this provision within the Patient Protection and Affordable Care Act empowers young health care consumers and I further fail to see how a provision of this nature does anything to help contain health care insurance costs which are spiraling out of control in our great nation.

Comments

[Darwin James]

Interesting points through out the article. But it'll still be a matter of time before we'll start seeing the long term effects of the system.

Darwin James
http://www.kanetix.ca/health-insurance

[Zara Leather Shoes less]

Interesting points through out the article. But it'll still be a matter of time before we'll start seeing the long term effects of the system.

Darwin James-Zara Leather Shoes less

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