Burgess Bill Requiring More Transparency In Health Insurance Plans Passes House
Shines light on exclusions buried within insurance plans, ensures individuals are aware of restrictions on health coverage
Washington, DC,
Mar 31 -
Bipartisan legislation requiring more transparency and up-front information on health insurance plans, introduced by Congressman Michael Burgess, M.D. (R-Texas), passed the House of Representatives today. This proposal would make a technical correction to the Health Insurance Portability and Accountability Act (HIPAA), and instruct health plans to notify individuals and employers of any exclusions or limitations on their health benefits at the point of sale.
“Individuals have the right to know what actions will and will not be covered by their health insurance plan, and this bipartisan bill takes an important step toward that goal,” Burgess said. “Many consumers or employers shopping for health care coverage are led to believe that care for a broken arm, for example, is the same regardless of how the injury happened – but that is not the case.
“Trip and fall at home and break your arm – no problem. Get bucked off a horse while on vacation with the family and break your arm – you may be slapped with the bill. This is simply unfair. The lack of clarity underlying these exclusions has created a confusing situation for individuals that may ride motorcycles, horses, snowmobiles, or participate in other activities that could result in an injury. Millions of Americans enjoy these activities safely every year, utilizing proper safety precautions and staying within the framework of state laws. They have the right to know if their health care coverage may punish them for simply enjoying their hobbies.
“We are hearing a lot about transparency these days – doesn’t it make sense to provide more transparency for Americans and companies shopping for health care insurance? Today we are going to stand up and shine the light on these exclusions so that Americans will not be caught off guard by exceptions buried deep within an insurance plan. This bill will take away that ambiguity and make sure that people are aware of any such restrictions on their coverage,” Burgess concluded.
This legislation is supported by several organizations, including the American Motorcyclist Association, Motorcycle Industry Council, American Council of Snowmobile Associations, American Horse Council, American Recreation Coalition, American Trails, Americans for Responsible Recreational Access, Blue Ribbon Coalition, International Mountain Bicycling Association, , Motorcycle Riders Foundation, National Ski Areas Association, Specialty Vehicle Industry Council, Sporting Goods Manufacturing Association, the Washington Road Riders Association, and many others.
Background
On September 23, 2008, the House of Representatives unanimously passed HR 6908. The legislation was received in the Senate but no action was taken. Congressman Burgess reintroduced the bipartisan legislation with Congressman Bart Stupak (D-Michigan) this Congress, HR 1253, the Health Insurance Source of Injury Clarification Act. The bill is identical to HR 6908 and will:
- Require that any limitations and restrictions on health plan benefits be explicit and clear;
- Require that they be disclosed to the sponsor of the group health plan in advance of sale; and
- Require that the issuer, in an easy to understand way, provide participants and beneficiaries a
description of the limitations and restrictions as soon as they enroll.
Congressman Michael Burgess, M.D., is a member of the House Energy and Commerce Committee and three of its subcommittees: Health, Energy & Environment, and Oversight & Investigations. He is also a member of the bipartisan, bicameral Joint Economic Committee. Prior to becoming a member of Congress in 2002, Congressman Burgess practiced medicine in North Texas for over 25 years.
