TMA Seeks New Standards for Health Insurance Sold Across State Lines

June 12, 2017    

The Texas Medical Association (TMA) is pushing for national consensus on standards to protect consumers who purchase health insurance across state lines. While a push continues to permit sale of insurance across state lines, little consensus exists among state legislatures and insurance departments on how to regulate in-state insurance companies and monitor how they treat their customers. To fix the problem, TMA’s Texas Delegation to the American Medical Association (AMA) House of Delegates will ask the body to adopt a resolution that supports interstate health insurance exchanges under certain conditions. The Texas physicians are meeting with colleagues in the AMA governing body at the AMA Annual Meeting in Chicago this week.

The proposed TMA resolution supports the interstate sale of health insurance IF minimum federal standards are established to protect both patients and their physicians and health care providers. The resolution suggests minimum federal standards should not weaken current states’ requirements on various insurance issues. Those include ensuring health plans enroll adequate networks of physicians to care for the policyholders/patients; have adequate medical liability provisions; and include financial protections for patients, physicians, and health care providers. Additionally, the proposal says patients purchasing an out-of-state policy should retain the right to bring a claim in state court in the patient’s home state.

David Henkes, MD, chair of the Texas Delegation, said Texas standards are a good starting point for the national debate. “We want to be sure that any changes concerning the sale of health insurance across strict state lines incorporate the many protections that already exist within the Texas Department of Insurance,” said Dr. Henkes.

Health insurance companies currently can sell insurance across state lines if the states have formed an interstate compact. The American Health Care Act, the federal health care reform bill proposed by Congress to replace the Affordable Care Act (ACA), also would allow the sale of health insurance across state lines if interstate compacts are in place. Georgia, Kentucky, and Maine each passed laws to permit these sales after the passage of the ACA in 2010.

Without consensus, health care advocates say health insurance customers could face increased cost and poor coverage. “When patients purchase health care insurance, it is important that they are informed and knowledgeable about what benefits they are purchasing and entitled to,” Dr. Henkes said.

The Texas physicians’ concern is that without standardized protections, Americans could face a patchwork quilt of plans and policies good and bad for patients. “If we continue in this direction, we must ensure our patients — their policyholders — are protected,” he said.

Over the weekend, AMA Delegates fine-tuned the Texas Delegation’s resolution by including similar language proposed by the New York Delegation and the AMA Council on Legislation. The AMA House of Delegates will consider the resolution this week.

TMA is the largest state medical society in the nation, representing more than 50,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.


Contact:  Brent Annear (512) 370-1381; cell: (512) 656-7320; email: brent.annear[at]texmed[dot]org

Marcus Cooper (512) 370-1382; cell: (512) 650-5336; email: marcus.cooper[at]texmed[dot]org

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Last Updated On

April 17, 2018

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