If there’s anyone who should know the ins and outs of the new health care law, it’s Julie Rovner, who was NPR’s health care law reporter until she left to join the Kaiser health news operation recently.
She, too, had heard — and reported — that the new law eliminated pre-existing condition exclusions, but when she switched jobs (and insurance companies) she found out it’s not what it appears, she writes on an NPR blog today.
Her new insurance company told her she has to wait a year, during which she will not be covered for any condition that existed prior to her taking a new gig.
It turns out there’s a snafu. She wasn’t credited for having insurance right up to the time she took the new job and under a ’90s-era law, you can’t be denied coverage for a pre-existing condition if you didn’t go longer than 63 days without coverage prior to starting a new job. She didn’t.
But the situation reveals a common misperception about the new law that could trap a few people, she writes.
Under the law, the only plans that may continue to exclude coverage for pre-existing conditions after that date are individual plans that are “grandfathered,” or haven’t changed substantially since the law was passed in 2010.
It turns out that the Jan. 1 date wasn’t quite as set in stone as many have thought. “It’s more of a rolling plan year effective date,” said a spokesman for the Department of Labor, meaning as plans renew in 2014, pre-existing condition exclusions will get dropped.
Indeed, a spokeswoman for Cigna confirmed that “for any particular group health plan, (the elimination of pre-existing condition exclusions) becomes effective on the first day of the ‘plan year’ that begins on and after January 1, 2014.” By the end of 2014, the spokeswoman said, the requirement to eliminate pre-existing condition exclusions “will have become effective for all plans.” And yes, the plan year for my new employer, The Kaiser Family Foundation, had begun before Jan. 1.
But what happens to a person who does have a break in coverage and gets a one–year exclusion in May but whose employer’s plan renews in September? Does that person get stuck waiting the full year until the next May for the exclusion to end?
Nope, says the Labor Department spokesman. When the plan drops the pre-existing condition exclusion, it goes away completely, including for those who it may be affecting at the time.
Related: For many with pre-existing conditions, Obamacare’s flaws are only a small price to pay (Chicago Tribune).