ACA proposed rules announced on pre-existing conditions, wellness programs

Government officials moved forward with Affordable Care Act provisions Tuesday that include banning health insurance companies from discriminating based on pre-existing conditions, outlining standards for coverage, and promoting employee wellness programs.

Starting in 2014, health insurance plans can vary in premiums based around factors such as age or tobacco use. But they may no longer deny coverage or increase premiums for pre-existing conditions, health status or factors such as a small employer size. While public and business sentiment around the ACA remains mixed, the provision is one of the more popular ones in the law.

The Department of Health and Human Services also announced a proposed rule concerning employee wellness programs. The maximum permissible reward under a plan can go up to 30% of the cost of health coverage and up to 50% for programs designed to prevent or reduce tobacco use. That may be good news for healthcare institutions trying to have their employees quit smoking or make positive lifestyle choices. Options include reimbursing the cost of membership in a fitness center or providing a reward to employees for attending a monthly health education seminar.

“Employers, too, can benefit from reduced costs associated with a healthier workforce,” Secretary of Labor Hilda L. Solis said.