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.
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,”
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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