In August, California lawmakers will discuss three important bills related to health care reform that may affect both consumers and insurers. The three bills tend to be opposed by insurers while consumers are considered to be the advocates.
What are the bills?
- SB1176 would require insurers to record any out of pocket costs made by plan policy holders and then any expenses that go over a set limit would be reimbursed by the insurer.
- AB1917 is a bill that is trying to decrease the costs of specialty medications for policy holders with chronic medical conditions. This bill would also require insurers to cover Hepatitis C screenings which are not currently covered.
- AB2533 would require insurers to pay for an out-of-network provider when there is not an in-network provider available. This is slated for review this fall.
What are consumer advocates saying?
These bills are meant to help consumers seek medical attention once they are enrolled in an existing plan. There have been issues with insurers like Anthem Blue Cross and Blue Shield of California for inflating their list of physicians covered in their provider networks. AB2533 would help patients who cannot seek treatment in network to go outside of their network without suffering high costs and financial burden. President Deborah Burger of the California Nurses Association also argues that access to physicians in-network is limited and the options are minimal. California is pretending like they are giving enough choices but in reality they are delaying proper care and treatment. These bills would help resolve some of those issues.
What are the opponents saying?
The California Association of Health Plans is saying that these bills are too expensive. Other opponents argue that these bills could bankrupt the private insurance marketplace because the cost to cover specialty medications would be too high. By enabling policy holders to seek treatment at out-of-network providers, that also hinders the ability to control healthcare costs.