Even if the Supreme Court declares the Patient Protection and Affordable Care Act (ACA) unconstitutional, UnitedHealth, the nation’s largest health insurer will still cover certain types of preventive care. The extensions will apply primarily to its customers who have individual policies or small-group health insurance through their employer, a minority of its 35 million total members. The ACA, whose goal is to provide coverage for millions of uninsured people, started unfolding in 2010 after health insurers fought to block its passage. Challenges to the law from states and other groups opposed to it wound their way to the Supreme Court. Bob Laszewski, a consultant and former insurance executive, UnitedHealth’s move a “very smart business decision.” The provisions are relatively inexpensive and are already factored into the coverage price. If insurers cut these benefits, customers probably will expect a corresponding premium drop, he noted. “It would probably be more trouble to roll these things back than go ahead with them,” Laszewski said. “It just makes common sense to leave these things in there and not take these benefits away since they’re already priced in.” Laszewski expects other insurers and large employers to take a similar approach.
The provisions UnitedHealth will maintain include providing coverage for dependents up to age 26 under their parents’ plan. The company will still offer certain preventive healthcare services without requiring a co-payment. These include yearly check-ups, screening for high-blood pressure and diabetes, and immunizations. Additionally, UnitedHealth will continue to forgo lifetime dollar coverage limits on policies. “The protections we are voluntarily extending are good for people’s health, promote broader access to quality care and contribute to helping control rising healthcare costs,” UnitedHealth Chief Executive Officer Stephen Hemsley said. “These provisions make sense for the people we serve and it is important to ensure they know these provisions will continue.”
The ACA is the largest overhaul of the $2.6 trillion American healthcare system in nearly a half century. It is designed to ultimately expand coverage to more than 30 million uninsured Americans, by setting up insurance exchanges and opening Medicaid for low-income Americans.
According to estimates, the ACA let approximately 6.6 million young adults remain on their parents’ health insurance plans last year, according to a report from The Commonwealth Fund. If the law is declared unconstitutional, Republican lawmakers may reinstate the extension of young adults dependent coverage. Other provisions that UnitedHealth plans to maintain include providing easily understandable ways for members to appeal coverage claim decisions; and eliminating rescissions, which are considered to be retroactive policy cancellations, except in the case of fraud. DeAnn Friedholm, director for health reform at the Consumers Union, called UnitedHealth’s actions “a positive step” and said she hopes other companies follow suit should the law be struck down.
Ronald Pollack, executive director of the consumer advocacy group Families USA and a supporter of the law, applauded UnitedHealth’s move. “It would make a huge difference for a great number of people who would otherwise be left out in the cold in terms of getting coverage,” he said. “And hopefully, given UnitedHealthcare’s market share, this would have tremendous influence on other companies.” Even if other large insurers follow suit, Pollack said, it would hardly make up for the loss of other provisions in the law that are set to take effect in 2014 — including subsidies to help low-income Americans buy insurance and bans against discriminating against adults with preexisting conditions.
Writing for CBS News, Stephanie Condon says that UnitedHealth’s decision “Could also alter the political fallout from the high court’s decision. Should the Supreme Court reject President Barack Obama’s law, he could point to UnitedHealthcare’s announcement to validate his policy agenda.”
The Associated Press’ Ricardo Alonso-Zaldivar points out that dismantling the ACA could be messy. “It sounds like a silver lining. Even if the Supreme Court overturns President Barack Obama’s healthcare law, employers can keep offering popular coverage for the young adult children of their workers. But here’s the catch: The parents’ taxes would go up. That’s only one of the messy potential ripple effects when the Supreme Court delivers its verdict on the Affordable Care Act this month. The law affects most major components of the U.S. healthcare system in its effort to extend coverage to millions of uninsured people. Because the legislation is so complicated, an orderly unwinding would prove difficult if it were overturned entirely or in part. Better Medicare prescription benefits, currently saving hundreds of dollars for older people with high drug costs, would be suspended. Partially overturning the law could leave hospitals, insurers and other service providers on the hook for tax increases and spending cuts without the law’s promise of paying more to offset losses.”