Rep. Hayes Introduces Bill to Protect Patients Against 'Junk' Health Plans

WASHINGTON, April 15 -- Rep. Jahana Hayes, D-Connecticut, issued the following news release:

Congresswoman Jahana Hayes (CT-05) and Congresswoman Jan Schakowsky (IL-09) introduced the Protecting Patients from Deceptive Health Plans Act to close a loophole that leaves patients vulnerable to being misled into purchasing insurance that does not have to comply with the Affordable Care Act (ACA) consumer protection provisions. This bill will protect consumers and American families.

"Junk plans fail Americans when they need healthcare the most. It is unconscionable that insurance brokers are allowed to prey upon vulnerable individuals and force them to pay out of pocket for care like prescription drugs and maternal health. As our nation moves towards pandemic recovery, comprehensive, affordable healthcare is more essential than ever," said Congresswoman Hayes. "When families are burdened with unexpected medical bills, they cannot put food on the table or make ends meet. We must bring an end to junk plans and protect the American people from deceptive policies."

"Junk health plans continue to plague our marketplace. When we passed the Affordable Care Act, we built in fundamental protections for Americans against discrimination and higher costs. Junk plans continue to discriminate for things like age, gender or having a pre-existing condition. These plans take money from consumers but fail to provide adequate coverage when they need it the most. I'm proud to join my colleague, Congresswoman Jahana Hayes, to introduce legislation that closes the loopholes that put American consumers at risk of unexpected medical bills and inadequate coverage", said Congresswoman Schakowsky.

Some forms of insurance coverage, known as "excepted benefits," are exempt from many requirements of federal law, including protections for pre-existing conditions under the ACA. These plans, also known as "junk plans," are not required to provide comprehensive coverage, such as coverage for mental health and substance use disorder, prescription drugs, preventive services, and maternity and newborn care. Excepted benefit plans such as indemnity plans may discriminate against individuals based on pre-existing conditions or health status, may impose annual or lifetime limits, and do not need to cap annual out-of-pocket spending for consumers.

The Protecting Patients from Deceptive Health Plans Act ensures insurance companies can no longer discriminate against individuals with pre-existing conditions by requiring policies treated as excepted benefits are paid without regard to illness, injury, diagnosis, or other characteristics related to the treatment. Furthermore, the legislation would also require these limited plans to only be sold to consumers already enrolled in comprehensive care that meets the requirements of minimal essential coverage.

The Protecting Patients from Deceptive Health Plans Act is endorsed by the American Lung Association and the Leukemia and Lymphoma Society.

"The American Lung Association is pleased to support Congresswoman Hayes' Protecting Patients from Deceptive Health Plans Act," said Harold Wimmer, National President and CEO of the American Lung Association. "This bill will protect American families by limiting the sale of non-comprehensive health plans and prohibiting discrimination based on pre-existing conditions for additional health insurance products."

"On behalf of the more than 1.5 million Americans living with a blood cancer diagnosis, the Leukemia & Lymphoma Society (LLS) is proud to support the Protecting Patients from Deceptive Health Plans Act. This is common-sense, reasonable legislation that will help protect the patients we serve," said Brian Connell, Executive Director of Federal Affairs of the Leukemia and Lymphoma Society. "The Protecting Patients from Deceptive Health Plans Act would close gaps and help ensure that patients are protected from sub-standard insurance products."