Alright, let's get started...
p. 1: what the hell does this have to do with first time homebuyers? I dunno...
pp. 2-17: table of contents. If no one objects, I'm going to assume this is correct.
p. 18: redesignations. yawn.
p. 19-22: brass tacks!!!!
So it says health insurers can't limit the amount of payouts in your lifetime, nor can it put "unreasonable" limits on the amount of payouts in one year.
Next it says insurance companies can't withdraw coverage once you're covered, unless you lie or commit fraud.
Then it says that the following will be covered, and covered 100%:
-recommendations that have an A or B effectiveness rating for preventive medicine (by the US Preventive Services Task Force)
-recommended immunizations (by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention)
-recommended preventive medicine and screenings for infants, children, and adolescents (by the Health Resources and Services Administration)
-additional recommended preventive care specific to women (by the Health Resources and Services Administration)
-current recommended practices (by the United States Preventive Service Task Force) for breast cancer screening, mammography, and prevention.
The Secretary will decide how long it takes for a new recommendation to become part of this list, but it has to be more than 1 year.
The Secretary can develop guidelines for insurance companies to create "value-based" insurance coverage.
If an insurance company covers dependent children, they must continue coverage until the child is 26.
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So... I think requiring coverage of dependents through 26, getting rid of annual and lifetime limits, and preventing ins. co.s from dropping your insurance once you've started (provided you didn't lie to them to get the insurance in the first place) are all great requirements.
For preventive medicine: this stuff will always change, and I think it's great that they name 3 specific groups of people who are qualified to decide what is the most effective in preventing disease, and forcing the ins. co.s to cover that stuff 100%.
Anyone have thoughts on the "value-based" programs?
Suddenly it all makes sense why the Health Resources and Services Admin changed the recommended screening age for breast cancer at the end of last year. It used to be 40. Doctors, the American Cancer Society, news anchors were all stumped and recommended ignoring that and still going at age 40.
And now, this bill gives your insurance company permission to refuse to cover the cost until age 50. Hopefully they'll happily cover the cost of treatment for an advanced stage of the disease that might have been detected by an earlier screening.
Methinks the insurance companies' lobby had something to do with this.
I don't know about the insurance companies being involved in that one... I think we've got to have a defined set of organizations responsible for making the list, and the USPSTF is probably the best one for the job. Did the task force cite any evidence that the 40 age wasn't effective enough?
The USPSTF said that "false-positive [mammography] results are more common for women aged 40 to 49 years." (http://www.annals.org/content/151/10/716.full)
However, they do say that "the decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms."
So, if one has a family history of breast cancer, it would seem like there should be some method to have those 40-49 mammograms covered by insurance.
Right Kate, but the recommendation to screen 40-49 year olds at risk only has a "C Rating", and as I read the law this won't require insurance companies to pay for any/all of the test even if you're high-risk.
Of course there's nothing to prevent an insurance company from including a high-risk, early mammography in an individual plan...except maybe the fact that they'll have to pay for it. There's a chance they'll find it financially beneficial to screen this group as compared to the (financial) risk of treating 50 year old patients with late-stage breast cancer.
It's true that they site false positives, and the emotional stress and extra cost associated with them, as the core reason. However, I couldn't find anywhere in their report the incidence of false positive vs actual positive. The report also said that it would be responsible to do studies to see what age it is most effective to start regularly screening for breast cancer. Which leads me to think that 10 years is a big jump. There are a number of other recommended studies to help refine current knowledge and advise on screenings and treatment effectiveness. The number and content of a lot of these recommended studies actually make me question how complete the study they're basing theses changes on is.
Every year, about 300,000 women in the US between ages 40 and 49 are diagnosed with breast cancer. It's true that there's a very low mortality rate for that age group currently. I am interested to know what that would change to should screening not start until 50.
Plus what Dustin said about the C rating.
I am just wary of the report because I have not heard of a single doctor that agreed with the change. Plus the American Cancer Society is still recommending to start screening at age 40.
...I think there are other points Dustin and I discussed off this forum. But it's Monday and I'm forgetting.
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