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Health reform pushes forward despite public opposition to gov't role Posted: February 28th, 2013

By Maryalene LaPonsie

In anticipation of the 2014 changes mandated by the Patient Protection and Affordable Care Act, the federal government has issued new rules regarding health insurance coverage in America. Meanwhile, a recent Gallup poll finds, for the first time, a majority of Americans say it is not the government's responsibility to ensure all residents have medical insurance.

Gov't rules address pre-existing conditions, wellness programs

The government rules were announced by the Department of Health and Human Services, which is responsible for implementing most of the health reform law, although the Department of Labor and the Treasury Department were also involved in the rule creation.

The rules address the issue of pre-existing conditions, standards for essential health benefits and workplace wellness programs.

  • Ban on pre-existing condition exclusions: Beginning in 2014, health insurance plans will no longer be able to deny coverage for those with pre-existing health conditions. In addition, they will be prohibited from charging these individuals higher premiums. The rule also prohibits insurers from charging policyholders more based upon their gender, occupation, small employer size or industry. The rule is intended to make affordable health insurance more accessible although companies will be allowed to adjust premium rates based upon an individual's age, family size, tobacco usage and geography.
  • Create standards for essential health benefits: To help consumers find low cost health insurance that provides the coverage they need, the government has proposed all health insurance plans offer a package of essential health benefits. These benefits are a set of ten core services that include, among others, prescription drugs, emergency services, hospitalization and maternity and newborn care.
  • Wellness program rules: As workplace wellness programs become increasingly popular, the government is proposing rules that are intended to assure these programs are open and fair to all employees. For example, one section of the rules states wellness programs must provide participants with a reasonable opportunity to improve their health and not be overly burdensome.

Public says gov't doesn't need to ensure coverage

While the country continues to prepare for the implementation of the 2014 health insurance mandate, the American public now says it is not the government's responsibility to ensure all residents have health insurance coverage. That's the finding of a recent Gallup poll and marks the first time the majority of the public has said ensuring coverage is not a role of the government.

Back in 2000, 64 percent of those surveyed felt the government did have a responsibility to ensure health insurance coverage for all U.S. residents. The number of those saying it's the government's responsibility peaked in 2006 with 69 percent supporting the premise.

The numbers have dropped steadily since then and in a November 2012 Gallup poll, only 44 percent of respondents said ensuring health insurance coverage was a government responsibility.