Ohio caps health-coverage cost

Insurers' premiums limited on policies for individuals with pre-existing conditions. People who pay dearly for health insurance - as much as $1,000 a month - because they have diabetes, cancer, kidney failure or other medical conditions soon will be able to save money.

A new state law took effect at the start of the year capping what insurance companies can charge people with pre-existing health conditions who buy individual policies. They can't be charged more than twice the lowest rate the company charges a person of similar age and gender. And by 2013, the cap will be down to 1 1/2 times the lowest rate, said Carly Glick, spokeswoman for the Ohio Department of Insurance.

Before this law, some companies charged four times the base rate. The cap is being phased in, Glick said, because health insurers said covering people with existing medical conditions is expensive, and those costs could be passed on to other consumers.

The cap is expected to reduce premiums by 50 percent to 70 percent for people who buy individual policies, and to make coverage more affordable for 52,000 uninsured Ohioans. Consumers can go on the Insurance Department's Web site - www.insurance.ohio.gov - to compare policies and costs of the 29 companies that do business in the state. Each company has to sign up at least 4 percent of its individual market share in this open-enrollment period, which doesn't expire until they meet their quota, Glick said.

Health insurers say the change is well-intentioned, but they're leery about the price of the policies their competitors will offer. No company wants to get stuck with the sickest of the sick. "If, for whatever reasons, we are the lowest-cost option you could easily get a pool of people who are consuming millions of dollars of health-care resources," said George Stadtlander, who is executive vice president and chief managed-care officer at Medical Mutual of Ohio. Patient advocates said the cap is a first step in ending what they see as the discrimination by health insurers against people with medical conditions. "Insurance companies have excluded people with pre-existing conditions from the insurance market for too long," said Cathy Levine, executive director of Universal Health Care Action Network of Ohio. "They couldn't afford or were denied coverage or were offered coverage that excluded the very condition that they most needed covered."

To learn more about open enrollment in Ohio, go to http://www.insurance.ohio.gov/Consumer/Pages/OpenEnrollmentToolkit.aspx

SOURCE: Suzanne Hoholik THE COLUMBUS DISPATCH