Rep. Oberlander to introduce bill to protect patients from health insurance policy changes

State Rep. Donna Oberlander (R-Clarion/Armstrong/Forest Counties) recently said that she plans to re-introduce legislation to protect patients already receiving a benefit within a policy year from changes in their health insurance contract.

The bill would amend Pennsylvania’s Unfair Insurance Practices Act to prohibit health insurers from changing the coverage or premiums in an insured person’s policy during the policy term when the person has already received a specific treatment, service or prescription drug.

“Many of us have encouraged our constituents to take control of their own health care needs by becoming diligent and smart shoppers in the health insurance marketplace,” Oberlander said. “We urge them to find a plan that provides needed coverage, including products, services, procedures, treatments and prescription drugs at a price they can afford. But what good does that do for our constituents if the health insurer can change its contract terms at any point during a contract year?

The bill is modeled after “Principle Number 5” of the American Medical Association, Prior Authorization and Utilization Management Reform Principles document. These policy principles are supported by the American Hospital Association, American Pharmacists Association, the American College of Cardiology and other groups.

The legislation would not affect an insurer’s ability to change covered benefits for insured people who are not already receiving a specific benefit. It would not apply to benefits removed because the U.S. Food and Drug Administration (FDA) have deemed them unsafe or prescription drugs that have been discontinued.

“I understand and support the important role health care insurers play in administering health care benefits in a cost-effective manner,” Oberlander said. “But I equally believe our constituents should get the coverage they paid for and have continued access to services and prescription drugs that are successfully treating their ailments.”

Oberlander urged her fellow lawmakers to join her in co-sponsoring the legislation.