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Obama proposes interim health protections

The regulations, all outlined in the healthcare overhaul bill, include barring insurance plans from denying coverage to children with preexisting conditions. Republicans call the rules a sales job.

June 23, 2010|By Noam N. Levey, Tribune Washington Bureau

Reporting from Washington — The Obama administration issued a series of proposed regulations Tuesday that would provide interim protections for Americans until the healthcare insurance market is more fully overhauled in 2014.

President Obama, meeting at the White House with people who had been denied care, also challenged Republicans who have been trying to repeal the healthcare law.

"They want to go back to the system we had before," Obama said from the East Room of the White House, where he signed the healthcare law 90 days ago. "I refuse to go back."

The regulations, all of which were outlined in the original legislation, include:

• Barring insurance plans, with some exceptions, from denying coverage to children under 19 with preexisting medical conditions.

• Prohibiting insurers from rescinding coverage except in clear cases of fraud.

• Prohibiting insurance companies from imposing lifetime limits on what they will pay for care.

• Banning insurers from imposing annual limits of less than $750,000 on coverage of essential benefits including maternity care, emergency services and pharmaceuticals. (The minimum annual limit would rise to $2 million by 2014.)

• Prohibiting insurers from requiring that their customers get prior approval before getting emergency care outside the provider network.

The proposed regulations would take effect in September.

Employer-provided plans that do not make major changes to their benefits or dramatically increase cost-sharing with employees would be exempt from some of these new mandates as "grandfathered" plans.

With health insurance premiums continuing to rise, the Obama administration has been working to highlight the immediate benefits of the new healthcare law to Americans who remain skeptical of the planned overhaul.

Administration officials estimated that as many as 200,000 children and adults could benefit from the protections, not counting several million who could gain easier access to emergency care, according to an analysis accompanying the proposed regulations.

Republicans quickly condemned the rules as a sales job.

"This shouldn't be called a healthcare bill of rights, but a bill of goods," Sen. Orrin G. Hatch (R- Utah) said in a statement. Hatch has sponsored legislation to repeal parts of the healthcare law.

Obama may face a bigger challenge as millions of Americans get double-digit premium increases. On Tuesday, the president explicitly warned insurance companies to restrain their rates.

"We've got to make sure that this law is not being used as an excuse to simply drive up costs," Obama said after emerging from a closed-door meeting with insurance executives and state insurance regulators.

Health and Human Services Secretary Kathleen Sebelius said the regulations should not push up premiums by more than 1 percentage point.

Insurance officials are evaluating the proposed regulations, said Karen Ignagni, who heads America's Health Insurance Plans, the industry's Washington-based lobbying arm.

Ignagni cautioned that insurers were being forced to raise premiums as medical costs climbed and healthy people dropped coverage. "Premiums are following underlying trends," she said.

The administration is working with state officials to step up oversight of the insurance industry, although the new healthcare law does not give regulators the authority to block rate increases.

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