Understanding health insurance can sometimes be difficult, but understanding the changes mandated by the Affordable Care Act can be even more cumbersome.
That's why Sen. Jay Rockefeller, D-W.Va., and Rep. Rosa DeLauro, D-Conn., have asked three federal agencies to create stronger rules so consumers can better understand their health coverage and determine the best insurance for them and their families. The two members of Congress also asked the Obama administration to reject calls from insurance companies and others who may attempt to weaken the regulations health care reform put in place.
The Affordable Care Act, passed last year, includes several provisions aimed to increase transparency and accountability in the often murky health insurance industry, based on a bill Rockefeller and DeLauro proposed in 2009. The provisions include simplicity and key facts on health coverage to consumers through the creation of standardized summary of benefits and coverage, including a coverage facts label for health care plans similar to the nutrition label on packaged foods.
Rockefeller said the 2009 legislation was important, and federal agencies should enforce the rules, because consumers should know what exactly they're purchasing.
"When spending money on a new purchase, most people examine all their options, comparison shop and try to make an informed decision," Rockefeller said. "People should be able to do the same thing before they choose a health insurance plan."
Rockefeller and DeLauro wrote a letter Nov. 22 to Kathleen Sibelius, secretary of the Department of Health and Human Services; Timothy Geithner, secretary of the Department of the Treasury; and Hilda Solis, secretary of the Department of Labor. The letter was encourage them to require health insurance companies to tell consumers about what is really included in their plan and to force companies to become more accountable by reporting data that will help regulators determine whether insurance companies complied with health care reform's consumer protections.
"For too long, a shameful lack of transparency has allowed insurance companies to hide vital information form consumers instead of competing based on the best value they can offer," the letter states. "When individuals buy cars or computers, they know exactly what they are buying and how much it will cost. Yet when it comes to making choices about health care coverage, it is often very difficult for consumers to tell what is actually covered and how much they will have to pay because the details of coverage are deliberately made obscure or shrouded in health insurance legalese."
The letter went on to outline four ways the three agencies could strengthen the rules, including:
n Allowing consumers to easily access the summary of benefits and coverage regardless of the source of their coverage
n Allowing consumers to access the summary of benefits before they commit to enrolling in a plan
n Allowing consumers access to coverage fact labels as required by the Affordable Care Act
n Implementing the rule so consumers are not forced to wait on access to information about their coverage
"The whole process can be confusing and overwhelming and for too long, insurance companies have profited off of consumers' lack of understanding their own health insurance policies," Rockefeller said. "We know that these new rules can empower consumers with better information to help them easily compare plans and find one that works best for them and their families."