On the surface, the minimum benefits requirement does seem to mandate comprehensive coverage. But another provision of the law works in the opposite direction, and the two have to be weighed together.
This second provision allows insurance companies to sell policies that have widely different levels of annual deductibles and copayments. A "platinum" plan would cover 90 percent of expected health care expenses, but on the bottom tier a bronze plan only covers 60 percent. Employer plans now cover about 80 percent.
"The minimum that people will be required to buy under the health reform law is clearly a catastrophic plan," said Levitt.
In return for taking on more financial risk, you'll pay lower monthly premiums for a bronze plan, making it easier to budget for. You'll be covered for the same kinds of treatments as everybody else, but your plan won't pay the hospital bill until you've spent a good chunk of your own money out of pocket.
A Kaiser study estimated that the annual deductible for a bronze plan could range from $2,750 to $6,350. The deductible is the amount a policy holder must pay directly before insurance payments kick in.
A separate study by the foundation found that people buying individual health policies in the current insurance market end up paying an average of 35 percent of their medical costs out of their own pockets, in line with the 40 percent consumers with a bronze plan would face.
While the bronze plan is available to anyone, the law also provides for another level of catastrophic insurance limited to people under age 30, and expected to be even skimpier.
Such nuances were seemingly lost before the Supreme Court. One of the lawyers representing the plaintiffs, Michael Carvin, asserted during the arguments that "Congress prohibits anyone over 30 from buying any kind of catastrophic health insurance."
Verrilli did not challenge Carvin's characterization, but it is raising eyebrows among insurance professionals.
"I don't think that's exactly right," said benefits lawyer Mark Holloway of the Lockton Companies, a major insurance broker serving mid-size companies. "It depends on what you call catastrophic coverage."
Carvin says he stands by his statement in court that the law prohibits anyone over 30 from buying any kind of catastrophic insurance.
"The bronze plan is not catastrophic coverage," said Carvin, who represents the National Federation of Independent Business.
"It's got all the minimum essential benefits in it," he added. "It's got to have wellness, preventive, contraceptives — all kinds of things a 30-year old would never need. It's not remotely catastrophic."
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