Insurer misrepresentations…

While Senator Steinberg was being sworn in as the new President Pro Tem on the Senate side, and calling for “health access for every Californian,” insurance company lobbyists were actively attacking Senator Steinberg’s health care bill, SB1522, on the Assembly side.

Without a strong case to make, they are resorting to outright misrepresentations of the bill, hoping nobody pays attention to the facts in the heated last days of session.

The bill is modest but meaningful. It would ensure that consumers have more confidence in their coverage.

Right now:
· It’s impossible to make price comparisons, since each plan from insurer has different deductibles, co-pays, out-of-pocket maximum, benefits, or networks.
· It’s hard to know what a plan covers, or doesn’t cover, or how comprehensive any given plan is.
· Some consumers think they are well covered, and find out they are not only when it is too late. Some plans are marketed as quality coverage but actually cover only hospitalization, but not surgeries, outpatient treatments, or doctor’s visits. (It would be like having car insurance, but only for accidents with red vehicles.) Some plans leave consumers with significant gaps in coverage, sometimes with unlimited exposure to medical bills.

SB1522 (Steinberg) does the following:
* Requires health insurance to cover doctors, hospitals, and preventive care
* Requires all health insurance to have a maximum out of pocket cost.
* Categorizes all health insurance into five categories so that consumers can know whether they are buying comprehensive coverage with low cost sharing or a high deductible, catastrophic policy.

Contrary to the misrepresentations of Blue Cross and other insurers, here is what SB1522(Steinberg) does NOT do:
* SB1522 (Steinberg) does NOT eliminate so-called “low cost”, low premium products with high deductibles. In fact, that’s why there are five categories, so that those products are better labeled.
* SB1522 (Steinberg) does NOT require all health insurance to cover specific benefits. There are other bills: AB1962 DeLaTorre requires maternity coverage, for example.
* SB1522 (Steinberg) does NOT force people to leave the coverage they have. Anybody with a current plan can renew it indefinitely.

These misrepresentations show why we need the bill: Just as consumers are rightfully skeptical about their insurance policies and what’s in the fine print, legislators should be skeptical of the claims of the insurance companies. The point of this bill is to give consumers more confidence that their coverage will be there for them when they need it. I am not sure there’s a legislative remedy for the representations of insurers in the halls of the Capitol.

Assemblymembers should join Health Access California, AARP California, ACORN California, AFSCME, CALPIRG, California Teachers Association, Congress of California Seniors, Community Health Councils, Consumers Union, Having Our Say, Jericho, Latino Issues Forum, MALDEF, MS Society, Planned Parenthood, SEIU, Small Business Majority, and Western Center on Law & Poverty in supporting SB1522(Steinberg).

Leave a Comment

%d bloggers like this: