Mandating health insurance

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Without limits on the number of visits, patients are encouraged to consume more services, and practitioners are induced to provide more, regardless of the incremental value of the extra services.New Uncertainty and Legal Jeopardy for Employers and Insurers.A set of provisions included in the Patient Protection and Affordable Care Act (PPACA)[1] gives the U. Department of Health and Human Services (HHS) sweeping new powers to impose a wide range of detailed benefit requirements on employer-sponsored health plans and major medical policies sold by health insurers.This will effectively make all health insurance benefits uniform—depriving patients of choices—increase the cost of coverage for tens of millions of Americans, and stifle insurance innovation.

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It also extends an open invitation to medical providers to lobby Congress and HHS to incessantly expand the “essential benefits.” The more benefits providers are able to have deemed “essential,” the more insurers, employers, and patients will have to pay for these services.While HHS could, in theory, take a restrained approach to setting minimum benefit standards, it is more likely that it will sooner or later impose increasingly detailed standards that result in higher plan costs.Greater regulation is the more likely outcome for two main reasons: (1) The Obama appointees at HHS are philosophically predisposed to favor such an approach, and (2) special-interest provider and patient groups have a natural incentive to lobby for more coverage requirements. The existing mental health parity statute does not require health plans to offer mental health and substance use disorder benefits; it only requires parity with other benefits if mental health benefits are offered.[8] However, Section 1302 of PPACA will require all plans to provide such benefits starting in 2014.In the United States, as well as some other countries, mandating that individuals buy individual health insurance has been proposed as a solution to high numbers of uninsured (in the US, the number stands around 47 million).The proposal is seen as both a way to force people to obtain something that is seen as necessary in a modern society, as unexpected illnesses or accident can suddenly overwhelm an individual with medical bills and frequently lead to bankruptcy.

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