Posted by AzBlueMeanie:
27 states defaulted to a federal marketplace health insurance exchange for purchasing health insurance — a major component of the Affordable Care Act — including Arizona.
6 states — Texas, Arizona, Alabama, Missouri, Oklahoma and Wyoming — have notified the federal government that their state insurance departments will not be policing the Affordable Care Act health care law.
In the 6 states that will not enforce the insurance exchange and market reforms, the federal government will have to review insurance forms and respond to consumer complaints about health insurance. Think Progress reports, These Six States Want To Allow Health Insurers To Deny Coverage To Sick People:
Officials in Texas and five other GOP-led states are refusing to oversee even Obamacare’s most basic — and popular — consumer protections and insurance market reforms. That includes the law’s ban on denying coverage or charging more because of a pre-existing condition and discriminating against women on the basis of gender. The decision could present major hurdles to Americans who buy health insurance through federally-run marketplaces in Texas, Arizona, Alabama, Missouri, Oklahoma, and Wyoming.
The Centers for Medicare & Medicaid Services (CMS) will instead be responsible for enforcing Obamacare’s insurance industry reforms and reviewing consumer complaints in the states refusing to do so on their own.
That could be confusing for Americans who are buying insurance for the first time through the marketplaces. For example, imagine you’re a relatively poor person with diabetes. Your income isn’t low enough to get you on Medicaid — but your employer doesn’t offer health benefits, and you’ve never qualified for insurance on the individual market because of your medical condition. On October 1st, you can go buy insurance with government subsidies for the first time on an Obamacare marketplace. But the plan you choose charges you a suspiciously high premium relative to your income. You suspect it’s because of your medical problem, which is clearly illegal under the reform law. But who do you complain to?
Usually the answer is your state’s insurance department. But the answer is CMS if you live in one of the six states that won’t enforce the consumer protections. Unfortunately, if you don’t know that, you could spend months oscillating between the state and federal government, trying to figure out if you’re getting hoodwinked by your insurance company. And in the meantime, the bills are piling up.
Those kinds of scenarios are the reason that health policy experts say insurance complaints are best handled by state agencies.
Maybe Arizona's media villagers should look into this and do some reporting on the Arizona Department of Insurance and provide some consumer protection and complaint resolution procedure information in advance of the October 1 start date for the federal marketplace health insurance exchange.