House bill seems to stop insurance companies from charging more for pre-existing conditions.

[Eric J in MN]

http://docs.house.gov/rules/health/111_ahcaa.pdf

SEC. 213. INSURANCE RATING RULES.
(a) IN GENERAL.—The premium rate charged for a
qualified health benefits plan that is health insurance coverage may not vary except as follows:
(1) LIMITED AGE VARIATION PERMITTED.—By
age (within such age categories as the Commissioner
shall specify) so long as the ratio of the highest such
premium to the lowest such premium does not exceed the ratio of 2 to 1.
(2) BY AREA.—By premium rating area (as
permitted by State insurance regulators or, in the
case of Exchange-participating health benefits plans,
as specified by the Commissioner in consultation
with such regulators).
(3) BY FAMILY ENROLLMENT.—By family enrollment (such as variations within categories and compositions of families) so long as the ratio of the premium for family enrollment (or enrollments) to the premium for individual enrollment is uniform, as specified under State law and consistent with rules of the Commissioner.

Let me know if you interpret this differently.

[Phoebe Loosinhouse]

1. it says (a) "in general"

which in and of itself is a big loophole.

Also, it is possible that prior conditions could be addressed elsewhere as their own specific topic. We will need to wade thru the entire bill with a fine toothed comb.

[lumberjack_jeff]

2. You're right.

all of the bills being considered implement rating criteria, none of which allow insurers to price those with preexisting conditions arbitrarily high.

The worst of the bunch is the Baucus bill which sets premiums at no more than a 7:1 ratio between the lowest risk customers and the highest.

[Romulox]

3. If they get to keep the same profit margins, it just means they'll charge everyone else more

Also, the effect of sub (1) is to shift a massive amount of cost from the old to the young.

[rucky]

4. Just thinking about how they can game this.

The max premium is limited as a ratio of the lowest premium - but doesn't give a floor or ceiling related to any solid numbers. If I were setting prices, I'd start with the costliest premium and divide by two to set the minimum - not the other way around, as I think the legislation hopes for.

Then it's up to the states to set the limits. I don't know enough about state insurance law to know what guarantees are provided there.

[T Wolf]

5. AGAIN - not worth a damn. The insurance corps cannot charge different premiums, but can

still refuse to pay for (or charge huge co-pays or other "out of pocket" expenses) to insure that the patient does not get the procedure.

Nothing in this travesty prevents this.