April 11, 2019

Warren, Colleagues Reintroduce Legislation to Hold Insurance Companies Accountable and Strengthen Consumer Protections

Senators' Bill Improves Affordability of Coverage and Prevents Trump Administration Sabotage of the ACA

Bill Text (PDF) | One-Pager (PDF)

Washington, DC - United States Senators Elizabeth Warren (D-Mass.), Kamala Harris (D-Calif.), Tammy Baldwin (D-Wis.), Kirsten Gillibrand (D-N.Y.), Amy Klobuchar (D-Minn.), Cory Booker (D-N.J.), and Richard Blumenthal (D-Conn.) today reintroduced the Consumer Health Insurance Protection Act to hold health insurance companies accountable and strengthen consumer protections in private health insurance. The bill builds on the progress made under the Affordable Care Act and includes provisions to improve the quality and affordability of health insurance purchased on the Affordable Care Act (ACA) exchanges or provided through employer coverage.

"A family's security can be swept away with just one bad diagnosis - just like with my little family back in Oklahoma. When I was 12, my daddy had a heart attack and we almost lost everything," said Senator Warren. "So long as private health insurance exists, there is no reason to allow our health care to be held hostage by insurance companies that refuse to do better. Our bill will hold them accountable while significantly improving access to health care for millions of Americans."

The Affordable Care Act made historic strides in expanding access to affordable, high-quality health insurance coverage and put an end to some of the most egregious practices that insurance companies used to shift costs onto patients. But today the more than 217 million individuals who rely on private insurance are facing rising out-of-pocket costs. Three out of every ten American adults with health insurance say they're having a hard time paying for their medical bills.

While insurers pull in hefty profits, too many patients have to battle with their insurance companies just to see a doctor or get a prescription filled. Insurance companies may draw their networks so narrow that patients struggle to find a doctor, drop doctors from their network in the middle of the year with no notice, and ambush patients who unwittingly relied on outdated provider directories with unexpected costs. Additionally, insurance companies may suddenly jack up out-of-pocket costs for a cancer or MS drug, or rip up a plan at the end of the year and leave patients scrambling to maintain access to their doctor. The top insurers in the country pull in the majority of their revenue from Medicare and Medicaid, even as some of these same insurers claim they can't afford to participate in the ACA exchanges.

The Consumer Health Insurance Protection Act:

  • Holds insurance companies accountable by putting an end to practices that hurt patients and requiring companies to live up to the same high standards that are set for private insurers when they participate in Medicare and Medicaid;
  • Sets up an ombudsman program to track consumer complaints about insurers;
  • Sets limits on insurance company profits to match those private insurers can earn in Medicare and Medicaid;
  • Protects against unreasonable premium increases with stronger rate review standards;
  • Requires insurers making money off Medicare and Medicaid to offer coverage on the ACA exchanges in areas with limited insurer competition;
  • Enhances the affordability of ACA plans by increasing premium tax credits, expanding cost-sharing reduction (CSR) subsidies, and making more families eligible for premium tax credits to guarantee that every individual on the ACA exchanges has access to a plan that covers 80% of out-of-pocket costs and costs no more than 8.5% of income in premiums;
  • Guarantees payment of CSRs;
  • Strengthens protections for essential health benefits;
  • Requires all short-term insurance products to meet ACA standards; and
  • Blocks the Trump Administration's regulations on association health plans. 

The Consumer Health Insurance Protection Act is endorsed by Families USA, Public Citizen and Community Catalyst.

“Families USA is proud to support Senator Warren’s Consumer Health Insurance Protection Act. This is a robust, comprehensive bill that is aligned with our mission to put consumers first.  It provides extensive reform to the private health insurance markets and strengthens consumer protections —including protections for individuals with pre-existing conditions.  We appreciate that the bill aims to improve our current coverage system—which is critical to any component of the next generation of health care coverage. We urge members of Congress to support this legislation that takes real steps to improve access to affordable health care for America’s families,” said Shawn Gremminger, Senior Director of Federal Relations at Families USA.

“In the face of Trump administration policies that are jeopardizing Americans’ health care and the health system, we applaud Senator Warren for introducing legislation that prioritizes consumers’ health, well-being and financial security. Building on the foundation of the Affordable Care Act, this comprehensive bill would make insurance more affordable, place limits on out-of-pocket costs for prescription drugs and strengthen consumer protections from surprise out-of-network bills, among other benefits. Senator Warren understands that Americans shouldn’t have to sacrifice comprehensive coverage for cheaper premiums. We applaud her for advancing pragmatic solutions that would address consumers’ most pressing health care concerns,” said Michael Miller, Director of Strategic Policy at Community Catalyst.

“The Consumer Health Insurance Protection Act would enhance health care affordability, increase transparency, and protect consumers from some of the worst abuses by private health insurers. The legislation would also put an end to surprise bills for emergency services, ending the fear that so many Americans have that one illness will lead to crippling medical debt or bankruptcy. Finally, the bill pushes back on Trump Administration efforts to sabotage our health care system and leave more Americans at risk for unaffordable health care bills. The reintroduction of Senator Warren’s legislation comes at a crucial time for defining the future of health care and Public Citizen welcomes her leadership on this vital issue,” said Lisa Gilbert, Vice President of Legislative Affairs, Public Citizen.