"Despite growing frustration with the way health insurers deny medical treatments, major healthcare bills pending in Congress would give patients little new power to challenge those sometimes life-and-death decisions," The Los Angeles Times reports. "Yet a patient's ability to fight insurers' coverage decisions could be more important than ever because Congress, in promoting cost containment and price competition, may actually add to the pressure on insurers to deny requests for treatment." The bills would require insurers to "cover everyone, regardless of pre-existing conditions," making it "more difficult for insurers to control their costs, or 'bend the cost curve,' by avoiding sick people. That leaves insurers with the other big cost-containment tool: turning down requests to cover treatments."
"Experts said the legislation under consideration does not significantly enhance patient protections against insurers refusing to cover requests for treatment. Most people currently have no right to challenge health insurers' treatment decisions by suing them for damages." The Employee Retirement Income and Security Act (ERISA) "bars suits for damages over health benefit decisions" for the 132 million people who get insurance through employers. Current health care bills do not remove the barrier (Girion, 10/19).
Source: Kaiser Health News