The Commonwealth Fund highlighted seven market reforms under the Patient Protection and Affordable Care Act that go into effect Jan. 1, 2014, including guaranteed access to coverage, a ban on pre-existing condition exclusions and requiring health insurers to vary rates on certain factors only.
While state insurance regulators said they can monitor health insurance sales and unfair trade practices, many said there are hurdles, such as past state court rulings, that limit what they can do in terms of enforcing reforms outlined in the PPACA.
In addition, 39 states have not taken any new regulatory action to implement health insurance reform provisions thus far. Eleven states and the District of Columbia have passed some type of legislation that enforces some or all of the health insurer reforms. Connecticut is the only state that has passed new laws or regulations on all seven reforms outlined.
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