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Insurers may protect some, but not all, health-care provisions that Supreme Court might void

This article first appeared in the St. Louis Beacon, June 13, 2012 - The head of a leading insurance industry trade association tried to reassure consumers on Tuesday that many of its member companies would keep certain provisions in the Affordable Care Act in place even if the law is voided by the Supreme Court.

The promise came from Karen Ignagni, CEO of America's Health Insurance Plans, a powerful industry voice based in Washington. She weighed in on the issue Tuesday, promising that the court ruling wouldn't necessarily change existing benefits to policyholders insured through AHIP members. AHIP provides benefits to 200 million Americans.

Ignagni said the group's priority was to provide "peace of mind" to policyholders and added that "no matter what the Supreme Court decides, individuals and families should rest assured that their current coverage will remain in effect."

While noting that each health insurer would make its own decision about coverage, she said that "many will maintain important patient protections," and that "consumers and employers will continue to have the option of purchasing coverage that includes many of the benefits they have today, such as allowing dependent children to stay on their parents’ policies until age 26."

She also said AHIP would take the lead in reforms to "promote prevention and wellness, help patients and physicians manage chronic disease, and reward quality care.”

At least three major insurers -- UnitedHealth Group, Humana and Aetna -- have told the Associated Press that even if the Supreme Court rules against the ACA, that won't prevent them from continuing to provide coverage to young adults up to age 26 and coverage for immunizations and other preventive care without requiring co-payments.

UnitedHealth Group and Humana are among Missouri's top 10 health insurers. Another major Missouri insurer, Coventry, did not respond by press time. But Blue Cross Blue Shield companies based in Kansas City and St. Louis seemed vague about continuing these services affected by a court ruling. Both companies mirrored the Blue Cross Blue Shield Association's stance that they "cannot speculate on how the Supreme Court might rule," but that they were "committed to providing stable coverage to our members that meets their health needs."

The statement made no direct comment about providing coverage that might not be upheld by the court. The association said it would encourage all 38 Blue Cross and Blue Shield Companies to offer customers "the broadest set of protections possible at an affordable price. Plans will be responsive to their members and the communities they serve." 

The Small Business Majority is praising insurance companies for promising to keep some ACA benefits regardless of how the court rules. Rhett Buttle, the group's government affairs director, calls the decision by the insurers "a first sign that ACA is working." He adds that the insurers were reacting to "provisions that are wildly popular with the public. We don't think this would have happened had it not been for the Affordable Care Act."

He says the preventive care provision was especially important to small businesses. "If you save money in the upfront by prevention, you can save a lot in the health-care system. That's a huge step for small business owners because we know cost is a growing concern."

Buttle added that allowing young adults to remain on their parents policies until age 26 was also beneficial to small businesses. "A lot of young people in the current economy are graduating from college and even from high school and are starting their own businesses," he says. Allowing them to remain on their parents' policies until age 26 "has made it helpful for young people who want to go out and be entrepreneurial." 

But Buttle says he is concerned that the insurance industry is silent on extending coverage for pre-existing conditions. ACA is making that possible by allowing people with pre-existing conditions to buy insurance thorough special health insurance pools. These are supposed to remain in place until the full ACA law is to take effect in 2014.

Not all Missourians support ACA, however. Voters approved a referendum in 2010, opposing ACA's mandate that consumers buy insurance or pay a fine. Unlike the Small Business Majority, the Missouri Chamber of Commerce and Industry has strongly opposed ACA. So have many Republican leaders in the Missouri Legislature.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.