Today, Congressman Jim McDermott (D-WA), the Ranking Member of the Ways and Means Subcommittee on Health, announced the introduction of the Medigap Consumer Protection Act of 2016 (H.R. 6265). This bill makes a number of long overdue reforms that will strengthen the Medigap supplemental coverage market.
Medigap plans currently cover approximately 11 million Medicare beneficiaries. However, many of the laws governing the Medigap market are largely unchanged since their last major overhaul in 1990. In particular, consumer protections have lagged behind other forms of insurance, leaving many beneficiaries subject to discriminatory market practices by issuers, enrolled in plans that are not necessarily right for them, and confused about their available options.
"Medicare beneficiaries deserve access to high-quality Medigap coverage," said Ranking Member McDermott. "The reforms made by the Medigap Consumer Protection Act will correct many of the problems that continue to exist in the market, including discrimination by issuers and a lack of information available to consumers. These reforms are long overdue, and I urge my colleagues to move to enact this bill without delay."
The Medigap Consumer Protection Act makes the following changes to federal law:
Expands guaranteed issue rights to prevent issuers from denying coverage to individuals with disabilities and End-Stage Renal Disease, as well as other beneficiaries who are not currently covered by these protections.
Calls on the National Association of Insurance Commissioners to update medical loss ratio standards to improve the efficiency of Medigap policies.
Provides for limitations on pricing Medigap policies based on age and disability or End-Stage Renal Disease, and requires issuers to price their products by county level.
Improves the Medicare Plan Finder website to facilitate beneficiary access to information and increase consumer understanding of available plan options.
Restores access to popular Medigap plan options that provide for coverage of the Part B deductible.
Increases transparency by requiring issuers to publicly disclose payments made to brokers that sell Medigap policies.
The Medigap Consumer Protection Act will significantly improve the beneficiary experience and strengthen the health security of millions of Americans enrolled in Medicare. Ways and Means Committee Ranking Member Sander Levin and Judiciary Committee Ranking Member John Conyers are original cosponsors.