Frequently Asked Questions: What You Should Know About the Affordable Care Act

1. Does EmblemHealth agree with the health reform law?
We see opportunities and challenges associated with the law. We are committed to complying with all provisions of the law and finding opportunities to serve our existing customers better while developing new products to attract new customers.

2. Will the health reform law generate savings for all stakeholders?
This remains the most unclear aspect of the law and will only be known as the rules and regulations from this comprehensive legislation are issued and implemented by the US Department of Health & Human Services. Benefit changes, mandates and the law’s multiple provisions will impact costs. As such, we will continue to look for increased value in health care and wellness.

3. Can EmblemHealth remain competitive in the marketplace if the health reform law is perceived as adding costs to health insurance?
Given the history of EmblemHealth’s legacy companies and the regional nature of all of them, we have the market strength and awareness to be well positioned. Also, the rules apply to all companies so we should not be adversely impacted any more than our competitors.

4. Where can I go to get a credible third-party review of health reform, rather than relying on potentially partisan sound bites in the mainstream press?
A respected third-party, unbiased source for health reform information is the Kaiser Family Foundation. You can also refer to a section-by-section review of the law.

5. Why aren’t all the rules and regulations from the law in place already?
The Affordable Care Act is complex and will be implemented over the next several years, requiring an extensive process to define the rules and regulations. We will update you as these rules and regulations evolve, so check back here frequently.

6. What is the essence of the law?
The health reform law clearly expands access to health insurance for those who may have had difficulty accessing coverage. This is the goal that the high risk pools and exchanges seek to achieve. Additionally:

  • Incentives to health plans, doctors and patients are included in the provisions to encourage preventive care and easy access to primary care.
  • Doctors will have incentives to improve outcomes and be more administratively efficient.
  • Fraud, waste and abuse carry heavier penalties than before.

Make sure to read this...
Effective September 23, 2010, federal health reform may require changes to your coverage, depending on your plan. Get more information.