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Protecting the Health Care Consumer
The Problem: Consumers pay too much for too little coverage
Americans pay a lot for their health coverage
- Employer based health premiums have doubled since 2000.
- Employer-provided health insurance for a family of four now costs $12,100/year
But they aren’t getting their money’s worth, because government has let
insurer put their profits before people. In most states, big insurers continue to:
- Deny or delay coverage for pre-existing health conditions
- Rescind coverage after care has been delivered
- Impose lifetime limits on coverage
- Require outrageous premiums and excessive cost-sharing from some consumers
The Solution: Guaranteed, Affordable Health Care
Congress must demand that insurers give every American consumer five simple
I. Guarantee that coverage won’t be lost due to illness or job status
- No denial, delay, or revocation of coverage due to pre-existing conditions or illness (Guaranteed issue and renewal)
- Individuals can keep their coverage when changing jobs
- Ban revocation of an insurance policy after it has gone into effect, for unintentional errors (non-fraudulent recissions).
- Prohibit excessively low lifetime caps on coverage
II. Guarantee coverage choices that everyone can afford
- Curb excessive premiums and cost-sharing
- Outlaw discrimination in coverage and pricing based on health status or history
III. Guarantee that premiums go to care, not profits or executive perks;
- Require that at least 85 cents of every premium dollar goes to health care, not administrative costs, executive compensation, or excess profits
- Require detailed, public disclosure of insurance company business practices
IV. Guarantee a fair hearing for anyone who is denied needed care
- Mandate independent appeals processes for consumers to quickly appeal insurers’ decisions to deny care
- Protect patients right to sue insurers for denying medically necessary care
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Tools & Resources
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