Conflicting bills try to implement, stymie health care reform

Conflicting bills try to implement, stymie health care reform

Tim Leeds

While Republican legislators are working to overturn the federal health care reform law, the state office which handles securities and insurance is working on creating laws to implement the reforms.

State Sen. Jonathan Windy Boy, D-Box Elder, said in an interview earlier this week that legislators were briefed on the bills that would set Montana's implementation of the Patient Protection and Affordable Care Act, the reform bill passed by Congress and signed into law by President Barack Obama in March.

"This would lay the groundwork for the state situation, how we will be dealing with that," Windy Boy said, adding that if the state does not set its own regulations, the federal government will step in to implement the changes.

The series of bills proposed for state Auditor Monica Lindeen's office are moving to the floor at the same time as a series of bills are working through the system to prevent implementation of some or all of the act, including a bill proposed in the Senate to force state Attorney General Steve Bullock to join a lawsuit trying to overturn the health care reform.

Other bills take action including declaring the federal act "invalid, null, void and unenforceable in Montana," and sending a referendum to the voters of Montana to allow all individuals and employers to choose whether to purchase or participate in health insurance, in opposition to a requirement of the health care reform.

Lindeen has requested four bills specific to implementation of the reform.

House Bill 105, sponsored by Rep. Robyn Driscoll, D-Billings, would provide the auditor with the authority to review and approve health insurance premium rates.

According to the fact sheet on the bill provided by the auditor's office, Montana is one of few states in the nation where the insurance commissioner, the auditor in Montana, does not have the authority to review and disapprove unreasonable rate increases implemented by health insurance companies.

If the legal authority is not granted to the auditor, the fact sheet says, the federal Office of Consumer Information and Insurance Oversight of the federal Department of Health and Human Services would enforce federal regulations on health insurance premiums in Montana.

House Bill 124, sponsored by Rep. Chuck Hunter, D-Helena, would create an online marketplace for consumers to compare rates, benefits and quality and help in the purchase of qualified health plans, the auditor's fact sheet said.

The plans would be placed on tiers based on out-of-pocket costs, with the plans offered by private insurance companies. The insurance offered would not be run by government or be a government-run plan, the fact sheet says.

House Bill 128, sponsored by Rep. Pat Noonan, D-Ramsay, would implement several specific requirements of the federal health care reform.

Those changes include:

• Prohibiting policies from placing lifetime limits or annual limits for essential benefits;

• Prohibit using pre-existing conditions in children younger than 19 to exclude them from insurance coverage, excepting some grandfathered plans;

• Requiring health plans that offer dependent coverage to extend coverage to dependents until they reach age 26, whether they are married or single;

• Prohibiting insurance companies from requiring a co-payment, co-insurance, or deductible for preventive health services;

• Allowing the choice of pediatricians as primary care physicians for children;

• Prohibiting cancellation of coverage due to a mistake by an applicant about their health information, with rescission only possible if an insured intentionally misrepresented material facts that relate to their health in the application.

The fact sheet says if Montana does not implement HB 128, consumers will have to ask questions and file complaints on these issues with the federal Department of Health and Human Services, which probably would set up a federal office in Montana to admister its operations.

House Bill 129, sponsored by Rep. Gary MacLaren, R-Victor, would implement the National Association of Insurance Commissioners model for insurance review and grievance and appeals processes for health insurance decisions. The existing Montana law on the process would be pre-empted by the federal law in July if HB 129 is not passed, the fact sheet says.

If the Montana law is pre-empted, the federal Office of Consumer Information and Insurance Oversight would oversee the process, the fact sheet says.

While Republican legislators are working to overturn the federal health care reform law, the state office which handles securities and insurance is working on creating laws to implement the reforms.

State Sen. Jonathan Windy Boy, D-Box Elder, said in an interview earlier this week that legislators were briefed on the bills that would set Montana's implementation of the Patient Protection and Affordable Care Act, the reform bill passed by Congress and signed into law by President Barack Obama in March.

"This would lay the groundwork for the state situation, how we will be dealing with that," Windy Boy said, adding that if the state does not set its own regulations, the federal government will step in to implement the changes.

The series of bills proposed for state Auditor Monica Lindeen's office are moving to the floor at the same time as a series of bills are working through the system to prevent implementation of some or all of the act, including a bill proposed in the Senate to force state Attorney General Steve Bullock to join a lawsuit trying to overturn the health care reform.

Other bills take action including declaring the federal act "invalid, null, void and unenforceable in Montana," and sending a referendum to the voters of Montana to allow all individuals and employers to choose whether to purchase or participate in health insurance, in opposition to a requirement of the health care reform.

Lindeen has requested four bills specific to implementation of the reform.

House Bill 105, sponsored by Rep. Robyn Driscoll, D-Billings, would provide the auditor with the authority to review and approve health insurance premium rates.

According to the fact sheet on the bill provided by the auditor's office, Montana is one of few states in the nation where the insurance commissioner, the auditor in Montana, does not have the authority to review and disapprove unreasonable rate increases implemented by health insurance companies.

If the legal authority is not granted to the auditor, the fact sheet says, the federal Office of Consumer Information and Insurance Oversight of the federal Department of Health and Human Services would enforce federal regulations on health insurance premiums in Montana.

House Bill 124, sponsored by Rep. Chuck Hunter, D-Helena, would create an online marketplace for consumers to compare rates, benefits and quality and help in the purchase of qualified health plans, the auditor's fact sheet said.

The plans would be placed on tiers based on out-of-pocket costs, with the plans offered by private insurance companies. The insurance offered would not be run by government or be a government-run plan, the fact sheet says.

House Bill 128, sponsored by Rep. Pat Noonan, D-Ramsay, would implement several specific requirements of the federal health care reform.

Those changes include:

• Prohibiting policies from placing lifetime limits or annual limits for essential benefits;
• Prohibit using pre-existing conditions in children younger than 19 to exclude them from insurance coverage, excepting some grandfathered plans;
• Requiring health plans that offer dependent coverage to extend coverage to dependents until they reach age 26, whether they are married or single;
• Prohibiting insurance companies from requiring a co-payment, co-insurance, or deductible for preventive health services;
• Allowing the choice of pediatricians as primary care physicians for children;
• Prohibiting cancellation of coverage due to a mistake by an applicant about their health information, with rescission only possible if an insured intentionally misrepresented material facts that relate to their health in the application.

The fact sheet says if Montana does not implement HB 128, consumers will have to ask questions and file complaints on these issues with the federal Department of Health and Human Services, which probably would set up a federal office in Montana to admister its operations.

House Bill 129, sponsored by Rep. Gary MacLaren, R-Victor, would implement the National Association of Insurance Commissioners model for insurance review and grievance and appeals processes for health insurance decisions. The existing Montana law on the process would be pre-empted by the federal law in July if HB 129 is not passed, the fact sheet says.

If the Montana law is pre-empted, the federal Office of Consumer Information and Insurance Oversight would oversee the process, the fact sheet says.