Coventry Health Insurance of Georgia (GA) | Health Insurance Georgia | Pros and Cons of Group Health Insurance Reform

Health Insurance Georgia

Pros and Cons of Group Health Insurance Reform

Health care reform is a huge news story right now. Although the health reform acts have been passed, and changes are starting to happen, a lot of government officials and politicians are speaking out for and against all of the changes. The main topic is whether there are enough monies in place to pay for all the changes that are required. Many of the changes required by the health reform acts start going into effect slowly, starting this year, and on through the year 2014. However, the tax increases will start effective this year. This is how the federal government will fund many of the group health insurance reform changes. There are also fees that group health insurance providers, hospitals, pharmaceutical companies, etc. will be required to pay or contribute towards the group health insurance reform.

However, some group health insurance carriers have stated they do not have the budget to contribute the necessary fees. In Massachusetts, the governor has prohibited group health insurance carriers from raising group health insurance premiums. All of the major group health insurance providers in Massachusetts are not-for-profit companies. Three of these group health insurance carriers reported operating losses in 2009. Therefore, without increasing their premiums, they would predict bigger losses in 2010. When the Massachusetts government prohibited them from raising premiums, these three group health insurance providers chose to stop selling group health insurance policies in April, because without the additional revenue, they state they would not be able to pay out on claims. This situation went to court, and state officials were threatening taxes and fees if they did not resume selling group health insurance policies. This story made big news in April because this is the sort of situation that those who oppose the group health insurance reform changes say will happen more and more frequently.

One sticking point for opponents of group health insurance reform is that health insurance providers will be required to charge everyone about the same premium, regardless of their health status or pre-existing conditions. This means that those who are healthy will have to cover the costs of those who have serious or chronic health conditions. This also means that people can wait until right before expensive medical treatment to purchase group health insurance, and therefore make other healthy members of the group pay for their costs. This is what will result in increased premiums for everyone. Several group health insurance companies have already reported an increase in short-term plan customers who have ran up costs, and then dropped the coverage a few months later.

Those who support group health insurance reform state this will help families who face bankruptcy due to lack of group health insurance coverage or whose claims are denied because of pre-existing condition exclusions, or who cannot afford high group health insurance premiums. The group health insurance reform rules and regulations also are supposed to end abuses in the insurance industry, including dropping coverage for people who become sick, charging women more than men, or setting lifetime or annual limits.

Everyone is taking a wait and see attitude about the group health insurance reform changes and how it will affect the health insurance industry, and in particular our personal monthly premium payments.

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