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Health Policy Program

Insurance Market Reforms

The new health reform law includes several insurance market reforms to ensure that all Americans can access quality and affordable health insurance. Several provisions will take effect immediately while others will be phased in over time.

Insurance market reforms include:

1. The elimination of pre-existing condition exclusions for children (and for everyone in 2014);

2. Dependent coverage for children up to the age of 26 for all group and individual policies;

3. The creation of a temporary national high-risk pool to insure individuals with pre-existing medical conditions;

4. Establishment of state or regional health insurance exchanges by 2014;

5. Restrictions on annual limits;

6. Prohibition of lifetime caps on benefits;

7. No rescissions;

8. Medical loss ratio requirements;

9. Preventive care and immunizations free of cost-sharing; and

10. Modified community rating provisions.


Required Reading

Making America's Insurance
Markets Work

Senate Finance Testimony
May 5, 2009

Addressing Insurance Market
Reform in National Health Reform

Senate HELP Testimony
March 29, 2009

New Health Insurance Marketplace
March 2, 2009

Across State Lines Explained

Policy Paper
October 8, 2008