Personal Choice and Responsibility
Requiring individual health benefit plans to issue plans without preexisting condition exclusions, waiting periods, or different terms or conditions based on health status, and applies requirements for mental health parity eliminates personal choice, which increases premium where coverage isn’t needed.
The federal Patient Protection and Affordable Care Act (ACA), enacted in 2010, contained a multitude of provisions impacting Medicare, Medicaid, and the employer and individual insurance markets. Many of these provisions went into effect in 2014 with the goal of reducing the number of Americans without health insurance. Key provisions included the individual insurance “mandate,” pre-existing condition protections, essential health benefit coverage requirements, and insurance premium subsidies. Senate Bill 250-A Prohibits health benefit plans from discriminating on the basis of actual or perceived race, color, national origin, sex, sexual orientation, gender identity, age, or disability. Exempts master group policies validly issued in another state from definition of “transact insurance” thereby giving out of state an advantage. Allows Director of Department of Consumer and Business Services to assess fees on exempt health benefit plans for the purposes of mitigating inequity in the health insurance market. Applies chemical dependency coverage requirements to individual health benefit plans that are not grandfathered increasing the premiums as dependency is a serious issue in Oregon. Exempts individual health benefit plans paid for through a health reimbursement arrangement from provisions applying to group health benefit plans. Permits DCBS to allow carriers to cap the number of enrollees in an individual health benefit plan if DCBS finds that issuing the plan to more individuals would have a material adverse effect on the carrier’s ability to fulfill its contractual obligations.