09 Dec 11 Health Insurance Regulations

The First Few Years of State-Run Health Insurance Regulations

Although regulations relating to health insurance were identified and put forward by Congress as far back as the 1930s and 1940s, they were never ratified at that time. On the other hand, the 1965 Social Security Amendments Act brought about Medicare to take care of the needs of families earning little. In 1993, the United States’ president at that time, Bill Clinton, initiated the bill of universal cover, but this also died down.

The regulations governing Medicare was made extensive in 1973 to include the medical needs of those under the ages of sixty-five, but with serious disabilities requiring serious medical attention. In 1988, Congress again made this scheme extensive to cover prescription medications. This bill became very unpopular and it was abolished in 1989 because funding solely came from taxing the elderly. Again in 2003, improvements were made on Medicare and the regulations governing it were modified to include prescription medications that had become very expensive and this was directly related to prescription medications that were much needed by the elderly.

If truth has to be told, the freezes in income that were required by law during the period of the Second World War was what principally caused employers to include health insurance in the pay pack of employees. This was thought to be a remedy to attract the much needed labour. This practice was kept alive and regulated by the 1985 Consolidated Omnibus Budget Reconciliation Act. This basically took care of the medical needs of those who were dependent on an insurance scheme or employees who were no longer working.

The main aims of the 1985 Consolidated Omnibus Budget Reconciliation Act was to make sure that if an employee was no longer active in service, those who were still dependent on him should continue receiving any benefits that could have been open to them, had the employee been in active service. 1996 saw the introduction of the Health Insurance Portability Act and this act was meant to take care of the health insurance needs of a workman who was no longer working, but who was in a process of getting hooked to another employment.

Given the fact that each state has been given the freedom to administer its own health insurance plans as it deems reasonable and fit for its citizens, some states such as Oregon have come up with rules and regulations to take care of the needs of those who have a sure and particular form of disability, rather than trying to see if this beneficiary will qualify for the health insurance benefits available. An example of this is the Oregon Health Plan.

In 1996, the Mental Health Parity Act was passed and this act acknowledged the awareness and frequency of psychological illnesses and it compelled every employee with fifty or more employees to provide health insurance to take care of psychological illnesses as any other health insurance scheme will do for conditions with physical illnesses. Yet still, employers were able to get of out of this by totally carrying on the burden health insurance to their employees and leaving the employees to take care of this in person. Still, there was nothing on the part of the legislative arm to redress this position of employers.

Health Insurance Regulations in California

In California, insurance is defined as an agreement under which the insurer agrees to take care of the loss or injury suffered by the insured as a result of some unknown cause. Any fraud on insurance is considered a very serious criminal offence in California.

The administration in California is doing much to protect the interests of the insured from the economic prowess of these insurers. What is being done is that a scheme is being advocated in which the insured will have the option of taking care of his or her own health insurance needs. This is also to avoid situations in which insurers have been known to have refrained from taking their responsibilities of indemnifying the insured. It is even thought that there should be a nationwide scheme in which every form of health insurance will be one and the same. But this thought is considered farfetched because the expenses needed to administer it may be difficult to be provided.