Summary of Bill:

 Health Insurance Coverage Protection Act

(S. 442 and HR 1085)

Background

Due to the high cost of care for some individuals affected by rare diseases, many reach their lifetime insurance limits within a few years, leaving them with no healthcare coverage. They are then forced to search out coverage with another private insurer, pay out-of-pocket, or turn to state health programs such as Medicaid. According to a 2007 Kaiser Family Foundation survey of employer-sponsored health plans (2007Annual Survey of Employer Health Benefits:

§        Over half of the employer-sponsored health plans and seventy percent of private individual insurance plans set aggregate lifetime caps on covered benefits

§        In some cases, smaller firms’ health plans lifetime caps are set at a higher level than those of large firms

§        76% of employer-sponsored HMO plans and 33% of PPO plans have no lifetime caps

§        Employer-sponsored plans with caps are most typically set at $2-$3 million

The Health Insurance Coverage Protection Act ―  recently reintroduced by Senators Byron Dorgan (D-ND) and Olympia Snowe (R-ME), and Representatives Anna Eshoo (D-CA), Jim Langevin (D-RI), Betty Sutton (D-OH), Dale Kildee (D-MI) and Jason Altmire (D-PA) ― would:

§        Raise the minimum level of lifetime caps for group health plans to $5 million for the first two years

§        Raise the minimum level to $10 million in years three and four

§        Raise the annual adjustments to lifetime caps in subsequent years based on the consumer price index

§       Not apply to any group health plan for a small employer (fewer than 20 employees) unless the employer wishes to participate

§       Require the Institute of Medicine to conduct a study to determine the number of individuals who have reached their lifetime limitations

Take Action Today!

Contact your Representative and Senators asking them to cosponsor the Health Insurance Coverage Protection Act:

1.       If you are not sure who your Senators and Representatives are, visit www.congress.org. Enter your zip code in the “My Elected Officials” box at the left and click “GO”

2.      Call the U.S. Capitol switchboard at (202) 224-3121 and ask for your representative’s or senators' offices. When connected, ask to speak with the legislative assistant (LA) who handles the issue

3.    After identifying yourself, including where you are from in the district/state, tell the LA that you support the Health Insurance Coverage Protection Act

4.       State the reasons why you support the bill

5.      Ask for their position and request that your Representative/Senator cosponsor the legislation. You may request a written response to your call

Remember– the ultimate authority of the U.S. Congress to act resides in you!