By Jennifer Blevins | Published May 18, 2017 07:23:30A new wave of medical coverage for Americans is forcing insurers to rethink their strategy of offering comprehensive coverage to everyone.
The Affordable Care Act mandates that all Americans get coverage from one or more health plans, known as catastrophic coverage, regardless of age or medical condition.
The National Health Insurance Plans (NHIPs), which are the industry leaders, are scrambling to ensure that their plans cover as many people as possible as they face pressure to lower premiums and cut costs amid rising health care costs and declining enrollment.
The industry, including National Health Plans, Blue Cross Blue Shield of Georgia, and UnitedHealth Group, is struggling to find the money to cover everyone, with some insurers refusing to cover patients with pre-existing conditions.
The companies are also scrambling to maintain the ACA’s essential health benefits protections, or EHBs, which were designed to prevent insurers from denying coverage to those with pre and chronic conditions.
This is particularly problematic for people who can’t afford coverage and rely on government subsidies to pay their medical bills, as well as those with preexisting conditions.
The Affordable Care Reconciliation Act (ACA) passed in 2010 and gave the states more flexibility in how they can expand coverage.
However, as the number of people with pre or chronic conditions continues to rise, insurers are facing a choice: Offer a broad coverage package to cover people with no pre-dispensing conditions, or limit coverage to older adults, low-income people, and people with existing conditions.
This is a major shift from past practice.
The problem is that the ACA doesn’t specifically require health plans to offer a broad range of coverage.
For instance, some health plans have offered only catastrophic coverage.
The ACA does not specifically require that insurers offer comprehensive coverage.
It says they must offer at least some coverage that includes “basic necessities” such as prescription drugs, maternity care, mental health, and prescription drugs for emergency services.
While some insurers may not be able to offer all the benefits they claim to offer, they are required to provide coverage at least as good as the federal government’s comprehensive plan.
That’s the only guarantee that they can provide, and insurers are only allowed to charge the same premium for this coverage as they do for their individual plans.
As a result, some insurers are offering catastrophic coverage to people with the lowest incomes, people with high incomes, and those who are currently enrolled in employer-sponsored health plans.
In the past, the companies that offered such catastrophic plans were the largest insurers in their states.
Today, however, many of the largest health insurers are struggling to maintain their positions.
The insurers are looking for ways to maintain these lower-cost policies, and they are doing this by limiting the number and types of people who are eligible to receive coverage.
They are also trying to convince insurers that they will be able provide a broader range of benefits and that they don’t need to offer catastrophic coverage in order to stay in business.
While many people have been receiving catastrophic coverage under the ACA, it is the policy of the health plans that are offering it to their customers that matters, says John P. Cogan, senior vice president and chief operating officer of Blue Cross and Blue Shield, the nation’s largest health insurance company.
“We believe catastrophic coverage is a great value for our members and will be a benefit to our members for many years to come,” he said.
Cogan said Blue Cross plans are offering a “limited” number of catastrophic plans, which is the same as the “standard” plan, the one that everyone has.
The company is not offering a catastrophic plan that is a universal coverage plan, which includes coverage for everybody.
Under the ACA health care law, people can qualify for catastrophic coverage by being enrolled in an employer-provided plan that meets certain criteria.
These include being a job-related death or permanent disability, being a student who enrolls at least half-time, having a pre-eminent medical condition that requires immediate medical attention, or having at least two chronic conditions that are “reasonably anticipated to result in death, serious disability, or long-term loss of independence.”
Cogan declined to identify which plans offer this type of coverage, saying the company was “focused on delivering the health care coverage that our members want and need.”
The plan does not have to include coverage for pre-emptive care or any pre-purchase of an individual health plan.
But it must include coverage of pre-payment medical and dental care, including prescriptions, lab tests, x-rays, and prescriptions for prescriptions.
The plan also must include a comprehensive list of all emergency services and mental health services that are provided, and must provide an EHB for those services.
A wide variety of insurance plans have similar policies, but they typically are not offered in all states.
The latest update from the Centers for Medicare & Medicaid Services (