273233 Rights of the insured under the ACA

Tuesday, October 30, 2012 : 10:30 AM - 10:50 AM

Elizabeth Abbott , Health Access, Sacramento, CA
A significant part of the policy work to assure that private insurers treat enrollees fairly under the ACA is being done by the National Association of Insurance Commissioners. As part of its work to protect Americans from predatory industry practices, the NAIC has invited health access advocates, to advise it. What share of insurers' revenue that should go to medical care (what insurers call their medical loss ratio) has been a particularly contentious topic. Another question is the design of a process Americans can use when they want to appeal insurers' decisions regarding their medical coverage. Also to be addressed is how the rights of people with certain health problems, called pre-existing conditions by the industry, are observed by insurers. This presentation will discuss policies that the NAIC is developing to answer these questions.

Learning Areas:
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Describe highlights of how the National Association of Insurance Commissioners is working to protect medical insurance enrollees under the exchanges.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to give this presentation based on 6 1/2 years as a public policy advocate at Health Access, 10 years as the Regional Administrator of CMS, and 3 years as an NAIC Consumer Representative.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.