Most states lack laws essential to enforcing ACA’s consumer protections

Thirty-nine states have not enacted laws essential to enforcing new consumer protection rules under the Affordable Care Act, raising the possibility of increased federal oversight, according to a survey by the Commonwealth Fund.

The Affordable Care Act enacted a number of consumer protections, including:

  • Banning insurers from discriminating against individuals with pre-existing medical conditions;
  • Capping out-of-pocket consumer costs;
  • Limiting waiting periods for new benefits to 90 days;
  • Prohibiting insurers from charging consumers more based on age, gender and health condition;
  • Requiring insurers to accept every individual and employer that applies for coverage;
  • Requiring insurers to cover 10 essential health benefits; and
  • Requiring insurers to cover at least 60% of costs.

However, the survey, which included responses from 40 states and the District of Columbia, found that just eight states reported having existing authority to fully enforce the rules. Meanwhile, 22 said they have limited or no authority to guarantee the ACA’s consumer protections.

If states fail to pass consumer protection laws, the federal government could step in, even though states typically regulate insurance markets. The ACA requires federal officials to take over when states do not “substantially” enforce the law’s seven new consumer protections.

2013-02-06T00:00:00+00:00 February 6th, 2013|Advocacy|