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Released: August 13, 2010

Insurance regulators face tough balancing act

Source: Julie Appleby, Kaiser Health News (USA Today)

A few months into a new job as a contract engineer, Jim Arey was stunned by an $8,000 bill he received for two doctor-administered infusions of an expensive drug he needs regularly. That’s when the Columbia, Md., man learned that the insurance provided through his placement firm capped doctor’s office care at $2,000 a year. He unknowingly hit his cap on his first visit because of the cost of the drug.

The new health overhaul law aims to end all annual dollar limits on health insurance policies by 2014. Federal regulators contend such limits can leave policyholders “virtually uninsured” for the rest of the year once caps are hit.

Starting this fall, most health care policies — except existing policies bought by individuals — will have to cover at least $750,000 in medical care per person. That ratchets up to $2 million by September 2012. But there’s a catch. Insurers can seek a waiver from the government to keep their current limited plans if they can prove that offering better benefits would cause significant premium increases or force employers to drop or severely limit coverage.

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