Changes to Individual Health Insurance Plans under ObamaCare

ObamaCare, or the Affordable Care Act, which was passed in 2010, was intended to give Americans equal access to health coverage and provide them with more control over their health care choices. ObamaCare overhauled the health care system and provided enhanced security for the millions of Individuals with pre-existing conditions and other issues that made finding affordable, high-quality insurance difficult or even impossible. One of the promises made was that those who liked their health insurance plans would be able to keep them. This includes individual health coverage policies. Insurance providers and employers would be granted the support needed to continue offering the same policies they always have. They will also be provided with a competitive health coverage marketplace: the state or federal insurance exchanges.

Being allowed to keep their personal health coverage policies minimizes the risk of coverage disruptions and enhances the competitive marketplace. ObamaCare has always been focused on a patient-centered system. All health insurance policies will be obliged to offer a certain minimum level of coverage, but those that existed before the Affordable Care Act was signed into law will have the option to be grandfathered in as long as they make only routine changes. Any significant cut to benefits or increased costs for consumers will result in a loss in grandfather status and requirements to comply with the new laws.

As of 2010, all personal plans should provide their subscribers with certain benefits and levels of coverage, regardless of whether the policy is grandfathered or not. The policy must not have lifetime coverage limits or rescind coverage when there is a major or chronic illness unless there is evidence of deliberate fraud or misrepresentation. Also, young adults may stay on their parents’ policies until they are 26, regardless of their marital or educational status.

New policies, or plans that are not grandfathered, will have additional protections for their subscribers. They will be required to cover recommended preventative health care services without requiring out-of-pocket expenses, and they must guarantee access to some specialists, such as pediatricians. Some plans will be exempt from the requirements, such as dental plans, retiree-only plans and Medi-gap plans.

An estimated 17 million Americans are currently in the personal health insurance market, and another 30 million are currently uninsured. The ObamaCare individual health insurance mandate will likely affect a large percentage of these individuals, increasing access to preventative services, improving access for those with pre-existing conditions and lowering health care costs across the board. The insurance exchanges slated to open in 2014 are intended to offer individuals and small businesses a variety of health coverage plans at competitive rates.

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