HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Thursday, May 14, 2009

The Informed Consumer Choices in Health Care Act of 2009

Time Magazine has a brief story on the many varieties of health insurance that individuals have and how difficult it is to figure out what will and will not be covered.  Karen Tumulty writes,

The fact is, it's hard to be an informed consumer when you are buying a product as complicated as health insurance. As Georgetown University's Karen Pollitz and a team of researchers discovered recently, even policies that look alike can offer very different coverage. They studied two policies in California, for instance, and found that someone undergoing a typical course of breast cancer treatment would end up spending under $4000 with one plan and more $38,000 with the other –- even though the two policies had offered similar deductibles, co-payments, and out-of-pocket limits. They summed up the problem this way:

Knowing whether insurance provides adequate coverage can be a challenge. Health insurance policies are complex products, highly variable in their design, and key information about how coverage works is not always disclosed during marketing. Further, health insurance promises protection against future, unknown events. Consumers who are healthy today can find it difficult to anticipate future medical problems and costs and harder still to evaluate how insurance might cover those needs . . . .

It turns out there are three people on Capitol Hill who agree. Senator Jay Rockefeller (D-W.Va.) and Congresswomen Rosa DeLauro (D-Conn.) and Allyson Schwartz (D-Pa.) plan to introduce a bill today that they are calling The Informed Consumer Choices in Health Care Act of 2009. Among its provisions is a requirement that insurance policies provide an explanation of the coverage they offer, similar to the nutrition label you now see on a packaged food. Something that looks like this, explaining how the policy would work under a variety of scenarios for various diseases and conditions like heart attacks and cancer. . . .

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