Some Aspects of Health Care Reform Costly, but Likely Here to Stay

Posted by Marla Roshkoff - 24 May, 2012


The Supreme Court's decision on the constitutionality of health care reform is expected within weeks. Whatever the outcome of the decision, it is very likely that some provisions of health care reform that have already been implemented, such as age 26 coverage and elimination of lifetime limits, will probably be here to stay.

Interestingly, compliance with these health care reform requirements may have increased costs for some benefit plans. Under health care reform, employers whose group health plans provide coverage for children must extend that coverage to children up to the age of 26, without increased cost-sharing. Employees have been taking advantage of the increased dependent eligibility age. Since employers must treat all children under age 26 the same way (and not charge more for children, for example, between age 23 and 26), employers are seeing increased costs under their plans.

Moreover, plans are required to eliminate annual/lifetime limits on essential health benefits. Plans that once included these limits may now be priced to take into account the increased potential liabilities due to the elimination of limitations on benefit payments.

We all wait for the decision of the Supreme Court on health care reform's constitutionality. What happens after the decision will also be carefully watched with respect to benefit plan operations.

Topics: Health Care Reform (ACA)

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