A California senator proposed legislation to protect patients with marketplace-based health coverage when insurers wind down individual exchange policies, Kaiser Health News reports.
In California, two national payers — Bloomfield, Conn.-based Cigna and Indianapolis-based Anthem — will scale back their individual marketplace businesses next year. The moves will leave more than 300,000 policyholders to find new plans. The insurers pointed to market instability and policy uncertainty at the federal level as reasons for their pullbacks.
As a result, State Sen. Ed Hernandez, D-West Covina, proposed legislation to protect chronically ill patients from insurance changes due to payers' exchange exits. Under Senate Bill 133, individuals forced to switch plans due to an insurer's marketplace exit would mandate any new plan provide the same coverage — including treatment by the same physicians — as the former plan. The proposal encompasses marketplace enrollees who are pregnant and chronically, acutely or terminally ill, the report states.
The coverage would be dependent on the physician being paid by the new health plan, the report states. The bill would also require the payer to cover the new policyholders' services through the same physician for a year. This provision would be prolonged for terminally ill patients, KHN states.