National Health Regulations (Amendment) 1991 No. 262
EXPLANATORY STATEMENT
Statutory Rules 1991 No. 262
Issued by the Authority of the Minister for Health, Housing and Community Services
National Health Act 1953
National Health Regulations (Amendment)
Paragraph (e) of the definition of "health insurance business" in subsection 67(4) of the National Health Act 1953 (the Act) provides that a kind of business not included in that definition may be prescribed.
Section 140 of the Act provides that the Governor-General may make Regulations for the purposes of the Act.
Section 67 of the Act, which was introduced from 1 September 1985, requires organisations conducting health insurance business to be registered under the Act. This provision was introduced to preserve the community rating principle, which forms the basis for private health insurance in Australia. Under this principle, all persons are treated equally for health insurance purposes regardless of such factors as age, sex, medical condition or family size.
It was subsequently found that the legislation impacted unfavourably on special groups such as sporting bodies, volunteer workers, youth associations (e.g. boy scouts and girl guides) and secondary school students undertaking work experience, particularly as insurance catering for the needs of these groups was not readily available from registered health benefits organisations.
As a consequence, National Health Regulation 29AAB (since renumbered to 48) was introduced to exclude from the definition of "health insurance business" such business as it related to such groups. This action paved the way for general insurance companies to offer health insurance cover for these groups.
The amendment to Regulation 48 allows general insurers to also provide health insurance cover for unemployed persons training under the Government's "Skillshare" program, which is administered by the Department of Employment, Education and Training.
Overview
The National Health Regulations (Amendment) 1991 No. 262, issued under the authority of the Minister for Health, Housing and Community Services, seeks to amend the National Health Act 1953 by modifying the definition of "health insurance business" to accommodate certain groups previously excluded from private health insurance options. This amendment was enacted to address the gap in health insurance coverage for special groups, including sporting bodies, volunteer workers, youth associations, and secondary school students, who were finding it difficult to obtain insurance from registered health benefits organisations. The policy objective behind this legislative amendment was to preserve the community rating principle in health insurance while ensuring that these specific groups were not disadvantaged. By amending the regulations, the government aimed to facilitate the availability of health insurance options from general insurers for these previously underserved groups.
Scope and Application
The National Health Regulations (Amendment) 1991 No. 262 pertains to the National Health Act 1953, specifically targeting the definition and regulation of health insurance businesses. This amendment applies to entities and individuals conducting health insurance business, particularly those not covered under the original definition, including special groups such as sporting bodies, volunteer workers, youth associations, and secondary school students on work experience. It also extends to include unemployed persons undergoing training under the Government's "Skillshare" program. The amendment allows general insurance companies to offer health insurance for these groups, thereby broadening the scope of who can be covered under health insurance schemes. The regulatory reach of these amendments is governed by the National Health Regulations, which are statutory instruments under the authority of the Minister for Health, Housing and Community Services. This amendment ensures that the principle of community rating is preserved while also providing necessary coverage for groups previously underserved by registered health benefits organisations.
Key Provisions
The key provisions of the National Health Regulations (Amendment) 1991 No. 262 amend the definition of "health insurance business" in the National Health Act 1953. Specifically, Regulation 48 now excludes certain types of health insurance business from the requirement to be registered under the Act, allowing general insurers to offer coverage for previously excluded groups such as sporting bodies, volunteer workers, youth associations, and secondary school students undertaking work experience (subsection 67(4) of the Act). Furthermore, the amendment extends this exclusion to cover unemployed persons training under the Government's "Skillshare" program, administered by the Department of Employment, Education and Training.
These provisions impose obligations on organisations and entities offering health insurance to ensure they comply with the regulations. General insurers now have the authority to provide health insurance to the excluded groups without needing to be registered under the Act, thereby facilitating broader coverage options for these specific demographics. This regulatory change necessitates that these entities adhere to the specific criteria outlined in Regulation 48, ensuring that their insurance products are appropriately tailored to meet the needs of the excluded groups.
Failure to comply with the requirements set out in the amended regulations can result in significant consequences. The Act does not explicitly outline specific offences or penalties for breaches of Regulation 48. However, non-compliance with the National Health Act 1953 generally can lead to legal action, including fines or other penalties as prescribed by the relevant laws. Additionally, the Minister for Health, Housing and Community Services retains the authority to enforce the regulations, ensuring that entities adhere to the legislative framework governing health insurance in Australia.