Health care presser update

BISMARCK — Certain provisions of the new health care law take effect Thursday, including changes for pre-existing conditions, lifetime limits and denied claims.

According to, insurers will no longer be able to deny coverage to youth younger than 19 with pre-existing conditions, put lifetime limits on benefits or cancel policies without proving fraud.

They also won’t be able to deny claims without a chance for appeal. That includes an external appeal to an independent reviewer.

Consumers in new health plans will be able to:

•Receive cost-free preventive services. New health plans must give you access to recommended preventive services, such as screenings, vaccinations and counseling without any out-of-pocket costs.

•Keep young adults on a parent’s plan until age 26. If your health plan covers children, you can now most likely add or keep your children on your health insurance policy until they turn 26 if they don’t have coverage on the job.

•Choose a primary care doctor, OB/GYN and pediatrician. New health plans must let you choose the primary care doctor or pediatrician you want from your health plan’s provider network, and let you see an OB/GYN without needing a referral.

•Use the nearest emergency room without penalty. New health plans can’t require you to get prior approval before seeking emergency room services from a provider or hospital outside your plan’s network – and they can’t require higher copayments or co-insurance for out-of-network emergency room services.

Sen. Tracy Potter, D-Bismarck, had a news conference Wednesday to point out aspects of the health care law and “overcome some of the confusion” surrounding it.

“For parents who have children who have pre-existing conditions, this is going to be a sigh of relief for them, that their children will be able to be covered,” said Potter, a candidate for the U.S. Senate.

Potter pointed to John F. Kennedy’s book, “Profiles in Courage,” saying it’s about politicians who stood against the popular tide and did what was right.

He said Republican challenger Gov. John Hoeven’s opposition to reform is based on what he considers to be the popular position and said that’s how Hoeven will approach the Senate.

“I will take the position that I believe is the correct one and has the biggest impact long term for the United States and North Dakota,” Potter said.

Hoeven campaign spokesman Don Larson said there are some good features of the law that come out on the front end. However, he said $500 billion in new tax increases and $500 billion in cuts to Medicare are coming.

“This is a 2,400-page bill that is going to lead to tens of thousands of pages of new regulations that put the government between individuals and their doctors,” Larson said.

Libertarian candidate Keith Hanson of West Fargo said solving “our supposed health care crisis” should involve less government involvement and more free-market competition.

“There is no question these (health care reform) provisions will benefit a small percentage of people, but in time we will find that this is one more case of a well-intentioned big government scheme that will not deliver on its promises and cost the average worker and small business owner much more than any politician will admit,” Hanson said.