Health care reform will change individual health insurance, but won’t destroy insurance companies

In his February 26, 2012, Health Stew blog on, HSPH’s John McDonough, professor of the practice of public health and director of the Center for Public Health Leadership, writes that he is encouraged by recent comments from Aetna CEO and President Mark Bertolini that the end of health insurance companies doing business as usual is at hand. Bertolini said that much-needed changes are underway in the industry, and that health care reform will not stop even if the Supreme Court strikes down aspects of the Affordable Care Act (ACA).

By ending medical underwriting, the process by which insurers cover individuals based on their perceived medical risk, and also banning exclusions for pre-existing conditions, the ACA will “mean the end of individual insurance as it has been known in most parts of the U.S.,” McDonough wrote. But in states where these changes already have occurred, including Massachusetts, insurance companies have survived and are doing fine, he added.

McDonough also wrote about the ACA in two other recent posts on his blog. On February 21, he shared stories published in the Denver Post about Americans whose lives have improved because of ACA provisions that already have been implemented, including the mother of a boy born with severe hemophilia. Lifetime caps on the child’s insurance coverage had placed his family in dire financial straits. Now that the ACA has banned caps, the family will no longer have to worry about losing coverage for his treatment.

McDonough lamented in his February 20 post that the recent agreement to fund short-term extensions of the payroll tax cut, unemployment benefits, and a 10-month delay in scheduled reductions in Medicare physician payments came at the cost of deep cuts to the health care law’s Prevention and Public Health Investment Fund, which covers wellness programs, screenings, and other public health activities.

“The public health community views the creation of the Fund as one of the most significant contributions to advancing public health ever. This cutback is a significant blow to that community, and an indication that the public health community needs help protecting its gains,” he wrote.

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