THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Friday, August 2, 1996 TAG: 9608020509
SECTION: FRONT PAGE: A2 EDITION: FINAL
SOURCE: KNIGHT-RIDDER NEWS SERVICE
DATELINE: WASHINGTON LENGTH: 81 lines
Help is coming for millions of Americans afraid to change jobs because of an existing medical problem, or worried that their insurance could be canceled if they get sick.
Today, final congressional approval is expected on a health-insurance bill designed to allay those fears. It also gives some help to small businesses and the self-employed.
When will it take effect?
July 1, 1997.
If I change jobs and have an existing medical problem, will I be able to get insurance coverage right away?
If you are like most workers, yes. If you've been covered by health insurance for the past 12 months, you won't need to wait to get coverage - even if you change jobs or switch insurance companies. You'll get credit for coverage under your old plan.
Are there any exceptions?
Yes. New workers just entering the job market still may have to wait one year for insurance. So may workers who haven't had insurance coverage recently.
How does this help people who change jobs?
It helps in two ways. First, it curbs most ``pre-existing condition'' clauses that made workers afraid to change jobs because a new insurance company could deny coverage for a previous or chronic health problem. That hit families especially hard. Second, it guarantees that workers who lose their jobs, quit or become self-employed will eventually be able to buy health insurance. They must have 18 months of prior coverage, not just 12.
Can my insurance company cancel my policy if I get sick?
Not anymore. Once the law takes effect, insurers must renew policies if the premiums are being paid and the rules are being followed. This has been a concern for people worried they'd lose their coverage if they got sick.
Will this law raise the cost of my health insurance?
There's some debate about this. Independent analysts and actuaries predict a ``minimal'' increase of between 2 percent and 5 percent. Some insurance companies say the cost will be greater. Other insurers expect almost no effect on rates.
Does this mean all insurers will have to cover all medical expenses?
No. Insurers will still be able to pick and choose what illnesses and conditions they'll cover. But they can't make you wait before offering coverage, in most cases.
Previously the Senate voted to include mental health-care coverage in the plan. Is that still included?
No. It was dropped after business and insurance groups complained it would be too expensive.
What does this law offer small business?
The incentives for small business were scaled back. Earlier versions let small businesses band together to negotiate better health-care deals. That provision was removed. However, small business does get first shot at offering medical savings accounts to their employees. The tax-free accounts allow employees to save money for medical expenses.
Does the law contain any help for the self-employed?
Yes. The cost of health insurance will become more tax-deductible. For now, health insurance is 30 percent deductible. With this law, that will gradually increase to 80 percent by the year 2006.
Does the law limit premium costs?
No. The bill has no limits on what insurance companies can charge. This is an area that most states - not the federal government - already regulate.
If I take time off between jobs, will that affect the pre-existing condition rules?
It could. If you go without coverage for more than 30 days, you'll be subject to an insurance company's pre-existing condition limits. So if you're changing jobs, it makes sense to arrange continuous coverage.
What happened to medical savings accounts?
They are tax-free savings accounts earmarked for paying medical expenses. They were controversial, and a compromise was reached. There will be a four-year pilot program in which a limited number of people (about 750,000) can participate. Small business and the self-employed with high-deductible medical plans will be eligible.
What does the bill say about long-term care?
It is designed to make long-term care, nursing home care and home health care insurance more affordable by making both premiums and out-of-pocket expenses tax-deductible. MEMO: Main story on page A1. by CNB