June 14, 2012

By TOM MURPHY | Associated Press


Some of the nation's biggest health insurers will keep some popular parts of President Barack Obama's health care overhaul even if the law fails to survive Supreme Court scrutiny later this month.

UnitedHealth Group, Humana and Aetna all said Monday that they will continue to cover preventive care such as immunizations and screenings without requiring patients to pay a set fee called a co-payment.

They also said they'd still cover adult children up to age 26 through their parents' insurance plans. Additionally, they all pledged to continue to offer a simple process for patients who want to appeal when their health insurance claims have been denied.

WellPoint, the nation’s second largest insurer behind UnitedHealth, said it will announce its plans after the Supreme Court’s ruling. The company runs Blue Cross Blue Shield plans in several states.

The announcements come after insurers initially fought to block passage of the overhaul, which aims to provide coverage for millions of uninsured people. Challenges from states and other groups opposed to the law, which was passed in 2010, made their way to the Supreme Court. Justices are expected to rule later this month on whether to uphold the law or strike down parts or all of it.

That major insurers are keeping some of the early provisions of the law underscores the popularity of those requirements. Patients have already gotten used to the benefits, and the insurers have already factored the cost of the provisions into the premiums that customers have to pay for coverage.

Bob Laszewski, a consultant in the insurance industry, said insurers have probably added about 3 percent to a patient's bill for the early provisions, depending on the type of coverage. As a result, he said it makes sense for insurers to keep the early provisions because if they didn’t, customers probably would expect a corresponding drop in the premiums they have to pay.

“It would probably be more trouble to roll these things back than go ahead with them,” said Laszewski, a former insurance executive. “It just makes common sense to leave these things in there and not take these benefits away since they’re already priced in UnitedHealth Group Inc. and Humana Inc., the nation’s No. 5 insurer, went further than No. 3 Aetna Inc. by saying they’d keep several early provisions of the law.”

Both companies said they won’t impose lifetime dollar limits on how much an insurance policy pays out to cover claims. That helps people fighting cancer and expensive, chronic illnesses. The two insurers also both said they would not pursue rescissions, or the cancellation of a person’s coverage retroactively, except in limited instances such as cases of fraud.

Both companies said in separate statements Monday that they decided to keep the provisions because they make sense. Humana said that its customers should “have the peace of mind” knowing that the company will keep the provisions even if the law isn’t upheld.

“The protections we are voluntarily extending are good for people’s health, promote broader access to quality care and contribute to helping control rising health care costs,” UnitedHealth CEO Stephen J. Hemsley said.

Still, the insurers stopped short of promising to extend an important initial overhaul provision that requires the coverage of children up to age 19 with pre-existing conditions. This gives children with expensive medical conditions a chance to land some sort of insurance coverage on the individual market to help pay bills.

A lone insurer keeping that provision might get overwhelmed with applications from children with expensive medical conditions who want the guarantee of coverage. UnitedHealth said it recognizes the provision’s value, but one company alone cannot extend the provision if the law is struck down.

The provisions that the insurers did keep don’t apply to everyone. UnitedHealth and Humana both say the ones they’re keeping apply largely to customers who have individual policies or small-group health insurance through their employer.

Big employers that pay their own medical claims and then hire an insurer to administer coverage generally make their own decisions on what to cover, and Laszewski, the consultant, expects them to extend some overhaul provisions as well.

Category: Health