Forum Session

Focus on Reform: Private Health Insurance Provisions
May 14, 2010

Manager

Kathryn Linehan

Summary

This session examined key changes to private health insurance in the Patient Protection and Affordable Care Act (P.L. 111-148). Speakers discussed near-term private insurance reforms such as high risk pools, extended dependent coverage, and capping insurers' non-medical expenditures. They also discussed large-scale reforms to the non-group insurance market that take effect in 2014, including: eligibility and rating rules, minimum benefits and other requirements for qualified health plans, risk adjustment, structure and function of health insurance exchanges, individual mandates for coverage, and premium credits and cost-sharing subsidies for qualified individuals.

Speakers

Bernadette Fernandez, Analyst in Health Care Financing, Congressional Research Service; Chris Peterson, Specialist in Health Care Financing, Congressional Research Service; Gary Claxton, Vice President, Kaiser Family Foundation and Director, Health Care Marketplace Project; John Bertko, Adjunct Staff, the RAND Corporation and former Chief Actuary with Humana

Slides from the presenations by Ms. Fernandez and Mr. Peterson are available for download, as are the speakers' biographies.

Related Materials

The Office of Consumer Information and Insurance Oversight (OCIIO) is responsible for implementing many of the provisions related to private health insurance in the Patient Protection and Affordable Care Act. Regulations and guidance from OCIIO are available on the U.S. Department of Health and Human Services Web site.

The Forum's series focusing on health reform also includes: "Medicaid Coverage Expansions" (May 7, 2010).

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