Government
House adopts health plan disclosure bill
■ The measure would prohibit insurers from enforcing exemptions that weren't spelled out in advance.
By Doug Trapp — Posted April 17, 2009
- WITH THIS STORY:
- » Related content
Washington -- Health insurers would be required to disclose coverage exemptions to employers and employees in easily understood language at the time that the coverage is purchased, according to a recently passed House bill.
The House adopted the Health Insurance Restrictions and Limitations Clarification Act of 2009 by a vote of 422-3 on March 31. A Senate version of the bill has not been introduced, but the legislation has been referred to the Senate Health, Education, Labor and Pensions Committee. The Senate did not act on an identical bill the House adopted unanimously in September 2008.
Rep. Michael Burgess, MD (R, Texas), the bill's sponsor, said insurers do not always clarify the types of activities that trigger health plan coverage exemptions. "Trip and fall at home and break your arm -- no problem. Get bucked off a horse while on vacation with the family and break your arm -- you may be slapped with the bill. This is simply unfair."
The measure would not allow health plans to enforce coverage exemptions unless the plans clearly disclose the exemptions ahead of time in writing. The bill would amend the Employee Retirement and Income Security Act of 1974, the Public Health Service Act and the Internal Revenue Code.
America's Health Insurance Plans has not taken a position on the bill. But AHIP spokesman Robert Zirkelbach said the organization supports "efforts to increase transparency so consumers know exactly what their plan covers."
A March 20 Congressional Budget Office estimate concluded that the measure would have negligible costs because the "issuers and sponsors of group health insurance plans generally make such information available and discuss plan information before and after enrollment."