House Bill Would Make Immediate Improvements

Unlike earlier versions of the House health reform bill, the one passed by the full House on November 7 contains several provisions that will improve access to health insurance immediately.  Many of the key pieces of reform, including the development of a health insurance Exchange and the Medicaid expansion for people living in or near poverty, will take time to implement, and will take effect in 2013.  But, the following provisions in the bill would take effect right away.

• Pre-existing condition exclusions in group health insurance (such as job-based coverage) limited to 3 months (down from 12 months currently).
• Lifetime benefit limits prohibited.
• A national “high risk pool” will be established to cover people with pre-existing conditions. Coverage will be better and premiums cheaper than in current Texas high risk pool.
• Health plans must spend 85% or more of premium dollars on medical care (as opposed to health insurance administration and profit) or issue refunds to consumers.  Currently, Texas has no similar standards in place.
• Children can stay eligible for their parent’s health insurance policy until they turn 27.
• Justification for premium increases must be submitted to state and federal regulators before the increase takes effect.  Currently, Texas requires no justification for premium increases for group health plans.
• People can keep COBRA coverage until the Exchange is up and running.  Currently, COBRA coverage is generally limited to 18 months.
• Reductions in health insurance benefits to retirees are prohibited unless they also apply to current employees.
• Anti-trust laws apply to health insurance companies.