Health care bill would protect pre-existing conditions
HARTFORD — Connecticut’s House of Representatives voted Wednesday to strengthen the health insurance laws by making sure residents with pre-existing conditions are protected.
House Bill 5521 passed unanimously by a 146-0 vote, and now goes to the Senate.
Rep. Sean Scanlon, DGuilford, said that they want to make it clear to the residents of Connecticut that “we will protect our constituents regardless of what happens in Washington.”
Scanlon said that one in four people, or 522,000 nonelderly adults, have preexisting conditions in the state of Connecticut, according to the Kaiser Family Foundation.
“Nobody should be discriminated against because they have cancer or they have heart disease,” Scanlon said.
The intent of the bill, Scanlon said, is to give Connecticut residents with pre-existing conditions, and their family members, “peace of mind.”
A few Republicans questioned Scanlon about the bill, stating they were primarily concerned about whether the legislation would increase the cost of insurance on Connecticut residents if the Affordable Care Act is eventually repealed at the federal level.
Tom O’Dea, R-New Canaan, was among those who expressed the concern during debate, and others also noted that the Connecticut Conference of Municipalities submitted written testimony in opposition to the bill as another mandate on municipalities.
“CCM is sympathetic to the intent of these proposals. However, state-mandated expansions of health insurance coverage would increase insurance costs for towns and cities,” they wrote. “These increased costs would result in higher premiums for municipal employers and most likely property tax increases.”
CCM also said the nonpartisan Office of Fiscal Analysis has concluded that such “coverage requirements may result in increased premium costs when municipalities enter into new health insurance contracts after January 1.”
But, in the end, the bill and Scanlon’s answers satisfy the chamber.
There is a lingering possibility that the federal Affordable Care Act will be repealed or a federal court could strike it down.
Scanlon said the legislation expands former Insurance Commissioner Katharine Wade’s August 2018 bulletins, which said that “any short-term limited-duration plan to offer the ACA’s essential health benefits for policies sold in the individual market,” and “any renewable short-term limited-duration health plan and any shortterm limited-duration health plan longer than six months cannot exclude pre-existing conditions.”
The legislation expands pre-existing condition coverage to plans shorter than six months.
A Connecticut law protecting pre-existing conditions for insurance policies that are longer than six months was on the books before the Affordable Care Act was signed into law in 2010.
Connecticut’s health insurance law — Chapter 7, Section 38a-476, already states that “no individual health insurance plan or insurance arrangement shall impose a pre-existing conditions provision on any individual.”
But that pre-existing coverage protection only applies to fully insured plans in the state.
In Connecticut there are
2.21 million privately insured residents. Of those, about 1.85 million get their insurance from large group plans,
131,000 have individual plans, and 235,000 people are covered under small group plans. The Insurance Department doesn’t regulate the plans of 1.85 million people in the large group market, where the terms of employee benefits are set by employers.
So of those 2.21 million privately insured residents, the 366,000 with individual plans or who are covered under small group plans are protected from losing coverage for pre-existing conditions if the ACA repealed or struck down by a court. Those with employer-provided insurance coverage in the large group market are not.
The bill the House passed Wednesday also doesn’t require documentation by a medical professional to prove someone has a pre-existing condition. Scanlon said that’s currently part of the ACA that they are looking to make state law.
Current law limits the provision to pre-existing conditions for which medical advice, diagnosis, care, or treatment was recommended or received.
The bill does not have a fiscal impact on the state or municipalities because it’s already current law.
Last year, Connecticut lawmakers passed HB 5210 to provide some extra protections to its health insurance law.
HB 5210 protects the ACA’s essential health benefits, such as prescription drug coverage, maternity care, pediatric services, and preventative care, for anyone who has a plan regulated by the state Insurance Department. It also requires some plans to provide preventative services for women, children, and adolescents at no cost.