Federal Healthcare Legislation Could Erode California’s Consumer Protections

Federal Healthcare Legislation Could Erode California’s Consumer Protections
Lisa Girion of the Los Angeles Times reports that a provision of federal healthcare legislation under consideration could harm consumer protections in states that have strong laws that both protect policyholders’ rights to insurance coverage for certain health treatments and the ability to appeal coverage denials. “State Health Laws at Risk,” Los Angeles Times, November 16, 2009. http://www.latimes.com/business/la-fi-mandates16-2009nov16,0,2437457.story. Healthcare overhaul bills in both houses allow insurers from other states to sell insurance in California without being subject to the state’s tougher enforcement mechanisms.

“California mandates require insurers to cover home healthcare, bone density screening for osteoporosis, in vitro fertilization and mastectomy. Mandates also cover certain providers, such as chiropractors, and conditions, such as autism. If insurers are allowed to sell under the laws of other states, they might be able to offer policies that do not include those benefits,” Girion writes.

Other California protections potentially at risk include prompt claims payment laws. In California, a policyholder has the right to appeal an insurer’s refusal to pay for a particular treatment. Other states may not offer the same protections.

Proposed federal healthcare legislation remains controversial. While on one hand it offers more competition and lower premiums for California consumers, on the other hand it could undermine gains consumers have achieved in California.

It’s always a good idea to read a policy before purchasing any kind of insurance. If something seems questionable or you don’t understand certain provisions, ask for explanations and help. Don’t sign any policy until you are convinced you will get what you pay for or are afforded the right to appeal when you don’t.

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