Health Reform: Context and Ideas for Covering This Week's Big Changes

Amid the election-season clamor over health reform and some major insurers' recent decision to stop offering new child-only policies, there are substantial changes rolling out on September 23.

Here are some ideas and context for covering them in your community. (You can also check out some leading journalists' ideas for your health reform coverage here and the Alliance for Health Reform's reporters' toolkit here.)

Context first: if you've been busy covering other topics, you might have missed the latest public opinion polls on health reform, the most recent partisan rhetoric, the GOP strategy, the administration strategy and general crazy punditry. Those links can help you get up to speed.

1. Young adults can stay on parents' health insurance plans until they are 26 years old. This is a key benefit for young people who can't find jobs offering insurance, can't afford or qualify for an individual policy, or are in graduate school. For a quick story, head to your local grad school and ask students (and then their parents) how they're affected by this change.  And check out Janet Lavelle's San Diego Union-Tribune story for some additional ideas.

2.  Health insurance policies sold after Sept. 23 must provide new preventive care services without charging a copay or deductible. This includes expensive screening tests such as mammograms and colonoscopies. Ask an insurance broker in your community whether insurers plan to raise rates after Sept. 23 to cover these added costs. Check in with cancer support groups to find patients who must undergo frequent screening tests to watch for a cancer recurrence – will they benefit from this change?

3. No lifetime limits on benefit payouts. This change will be phased in over time and has a number of loopholes. Again, local disease associations and support groups are your friend: check in with patients with chronic diseases requiring expensive medications (multiple sclerosis is one) about how their financial outlays might change. 

4. Insurers can't deny children under 19 coverage because they have a pre-existing condition. This applies only to new policies issued after September 23 and not existing policies. This provision affects about 500,000 children nationwide; however, some major insurers have announced that they will no longer offer child-only policies after September 23 to avoid what they call potentially huge financial losses. That's because parents could avoid buying a policy until their child became ill, knowing that the insurer could not turn the child down. The Incidental Economist blog explains the issue in this post. Check with parents in your area: do they need individual policies for their children? Would they wait until a child got sick? How will local brokers handle children-only policies if so few insurers offer them?

5. Rescissions are banned. Some insurers have methodically searched for an error or other mistake on a policyholder's initial application, using that error to deny payment when the policyholder became ill. This is now illegal. Check out Lisa Girion's ReportingonHealth essay on rescissions for good background information. Check in with lawyers handling ongoing rescission cases – what will happen to their clients now?