Many States Lack Legal Authority To Regulate Some Health Law Details
Nearly half of all U.S. states lack the legal authority to regulate health insurance premiums and enact the consumer safeguards scheduled to take effect next month under the federal health reform law, according to a recent government survey of states, the New York Times reports.
In the survey, state regulators indicated that they currently do not have the authority to enforce certain provisions of the overhaul. The states are:
- California;
- Florida;
- Hawaii;
- Michigan;
- Nebraska;
- Oklahoma;
- Virginia; and
- Wyoming.
Specific Provisions
The provisions in question:
- Require insurers to provide health coverage to children younger than age 19 regardless of pre-existing medical conditions;
- Allow dependents up to age 26 to remain on their parents' health policies; and
- Prohibit insurers from charging consumers higher copayments for preventive services, imposing lifetime limits on benefits, or denying benefits or rescinding coverage except in cases of fraud or intentional misrepresentation.
How To Regulate?
Federal and state officials are searching for ways to ensure that the regulations are enforced.
Some state insurance regulators have suggested that state lawmakers expand the regulators' authority by adopting the new federal standards into states' laws next year. Other state regulators will seek to ensure compliance by insurers through their power to oversee insurance policy forms and contracts, while others plan to:
- Persuade insurers to comply;
- Rely on insurers' good will; or
- Rely on existing state laws to rein in improper insurer practices (Pear/Sack, New York Times, 8/14).
HHS To Grant $46 Million To Help States
Meanwhile, HHS on Monday is scheduled to announce $46 million in state grants as part of a five-year initiative under the federal health reform law to help states enforce new regulations on health insurance companies and implement various consumer safeguards, USA Today reports.
The District of Columbia and 45 states that applied for the grants are expected to each receive $1 million to:
- Help curb insurance rate increases;
- Hire insurance rate experts; and
- Set up websites with insurance policy rates and other data for consumers.
The grants were available to all 50 states and the District of Columbia, but Alaska, Georgia, Iowa, Minnesota and Wyoming did not apply for them.
HHS records of the new grant applications show that 15 states and Washington, D.C., intend to use the money to expand their powers to supervise insurers, while others plan to hire actuaries and others to scrutinize rate filings (Young, USA Today, 8/16).
This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.