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UnitedHealth Group Inc
UnitedHealth Group Inc. (UNH), Aetna Inc. (AET) and Humana Inc. plan to retain some benefits created by the U.S. health-care overhaul even if the Supreme Court strikes down the law. The exception: Those involving people with pre-existing illness.
Customers of UnitedHealth, the largest U.S. health insurer, can keep children on plans until age 26, get free preventive care and won’t face lifetime benefit limits, the Minnetonka, Minnesota-based company said yesterday in a statement. The insurer also won’t rescind policies except for cases of fraud and will retain a simplified appeals process for denials.
Aetna, the third-largest health insurer by market value (AET), said today it would cover preventive services, let young adults stay on their parents’ plans and continue outside reviews of coverage denial appeals. Industrywide implementation of those and other provisions of the 2010 health care law has been in doubt as the Supreme Court prepares to rule this month on whether a key measure of the overhaul is constitutional.
“A number of provisions in the health-reform law have been woven into the fabric of our health-care system, bring value to customers and consumers, and should be maintained,” Hartford, Connecticut-based Aetna said in an e-mail.
Humana (HUM) said today it would maintain various coverage provisions, all of which match UnitedHealth’s pledge.
“Humana believes its health plan members should have the peace of mind of knowing the company embraces and will maintain these common-sense provisions that add stability and security to health-care coverage,” the Louisville, Kentucky-based company said in a statement.
UnitedHealth said it can’t cover children with pre-existing illnesses unless other insurers also agree to cover them, and that it would work with “all other participants in the health- care system” on the issue. None of the companies addressed the issue of covering adults with pre-existing conditions. Other insurers will probably follow UnitedHealth’s lead, said Les Funtleyder, a portfolio manager with Miller Tabak in New York, before Aetna’s statement.
“As United goes, so goes the world,” said Funtleyder, whose Healthcare Transformation Fund owns UnitedHealth shares. “The reason insurance companies didn’t do it in the first place -- they can price for all of these things -- is because they were afraid of competition.”
The Supreme Court is weighing whether the law’s mandate that most Americans be insured is constitutional and, if not, whether to strike down the entire law or just that part of it. The law, supported by President Barack Obama, was passed without Republican Party support.
Nick Papas, a White House spokesman, declined to comment on the insurers’ actions.
The benefits and protections UnitedHealth would preserve probably don’t cost much or add more than “a couple of dollars” to premiums, Funtleyder said in a telephone interview. UnitedHealth had about 25.9 million people (UNH) in its commercial plans in 2011, according to data compiled by Bloomberg.
The company said it won’t change its 2012 earnings forecast because of the announcement. The cost of single benefits such as free preventive care can’t be easily isolated from the variables that determine premiums, Matt Stearns, a UnitedHealth spokesman, said by telephone.
The requirement that insurers let families keep children in their plans until age 26 expanded insurance coverage to about 2.5 million people in 2011 while increasing premiums less than 1 percent, the government estimates.
The provision is among the most popular parts of the law, polls show, and the nonprofit Commonwealth Fund in New York estimated last week that about 6.6 million young adults are on their parents’ plans because of it.
The government has estimated that prohibiting lifetime limits on benefits also adds less than 1 percent to premiums.
“The protections we are voluntarily extending are good for people’s health, promote broader access to quality care and contribute to helping control rising health care costs,” UnitedHealth Chief Executive Officer Stephen J. Hemsley said in the statement.
Ron Pollack, executive director of Families USA, a consumer advocacy group in Washington that backs the health-care law, called UnitedHealth’s statement a “very positive development.”
“This in no way changes the importance of making sure the Affordable Care Act is fully implemented,” Pollack said in a telephone interview. He said he hopes other insurers don’t “undermine” UnitedHealth’s position by offering plans with lower premiums that don’t guarantee the same protections.
Aetna said it also planned to continue collaborations with hospitals and doctors through so-called accountable care organizations, in which health providers closely monitor and coordinate care for patients in an attempt to lower health costs.
The health law, the company said, “has propelled interest in exploring new ways to deliver care.”
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