Meanwhile, Texas and Michigan are seeking waivers from the law's medical-loss ratio rule and the Department of Health and Human Services posts information about patients' appeals rights.
Kaiser Health News: States Face Challenges In Controlling Health Insurance Premiums
For many consumers, the ultimate test for the embattled health care law is simple: Will it push down insurance premiums — or at least slow their relentless rise? It's a pressing question for the Obama administration, which is hoping its signature domestic policy achievement doesn't end up as an election year albatross (Appleby, 8/7).
The Associated Press: Religious Groups Object To Covering Birth Control
They defied the bishops to support President Barack Obama's health care overhaul. Now Catholic hospitals are dismayed the law may force them to cover birth control free of charge to their employees. A provision in the law expanded preventive health care benefits for women, and the administration said last week that must include birth control with no copays (Alonso-Zaldivar, 8/7).
San Francisco Chronicle: Domestic Violence Spotlighted In Health Plan Rules
This week's groundbreaking decision by the U.S. Department of Health and Human Services to require health plans to cover domestic violence counseling without requiring a co-pay will give women and their health care providers an important new incentive to call out the distress signals of abuse, and to take action. Domestic violence is a widespread, harmful and expensive public health issue. Public awareness campaigns, advocacy groups and laws offer support and a way out, but too many individuals remain isolated and stigmatized (Schaffer, 8/5).
CQ HealthBeat: A 'No' to a Guam MLR Waiver, While Texas and Michigan Make Their Pitches
The Department of Health and Human Services on Friday turned down a request from Guam that it be given a waiver from the medical loss ratio rule in the health care law. The market in Guam is so small, the territory wouldn't be penalized if it didn't meet the standards in the rule, federal officials said. Meanwhile, Texas' and Michigan’s insurance commissioners have written to HHS asking for waivers for their states, saying that if they had to comply immediately with the MLR standard, their insurance markets would be disrupted and there would be problems for consumers. Two powerful Republican lawmakers also wrote letters pushing for a waiver for Michigan (Norman, 8/5).
CQ HealthBeat: HHS Officials Post Information About Patients' Appeals Rights
Insurers in 17 states, the District of Columbia and the five U.S. territories will have to use federal external reviews of denied claims because those governments did not put in place their own locally based process. The health care law entitles patients to internal and external reviews when their medical claims are denied. Such patient protections had long been promoted by consumer advocates, who pushed for their inclusion in the late 1990s during congressional debates on a patients' bill of rights. The law requires companies to explain to patients why a claim was denied or coverage was dropped. Enrollees have a right to demand internal reviews of their appeals by the insurer and then to go to an outside review board if the internal appeal fails (Adams, 8/5).