As it moves closer to a vote by the full legislature, Hawaii Bill SB1217 has been re-amended to its original focus, which is protecting all licensed care providers from insurer discrimination.
Last month a version of the bill passed through state senate committees with a primary focus on protection for naturopathic physicians. This changed the original intent of the state law, originated in 2014, to mirror the provisions of Section 2706 of the Affordable Care Act, “Non-discrimination in healthcare.” Earlier this year, because of previous laws on the books protecting specific holistic professions – acupuncturists and chiropractors – it was thought that a similar focus on naturopathic medicine was appropriate and would not duplicate protections for other providers.
That approach is different from the language used in New Mexico, for example, in which previously written legal protections for specific holistic disciplines would be replaced by the umbrella protections of “all-licensed providers,” as is specified in Section 2706.
In part because of requests by Kaiser Permanente, the language of the Hawaii bill was re-written again to mirror the language of 2706. As in many other states, insurers are opposed to a state adopting an “any willing provider” provision (such as is in effect in the state of Washington), which restricts insurance companies from controlling the number and types of professionals that it must include in its provider networks.
Kaiser asked for the bill’s language: “…to be aligned with the same requirements of Section 2706(a)…By not doing so this bill would be inconsistent with federal law.”
But Section 2706 does not even hint at a requirement that any state initiating its own version of the provision has to use its language. In fact, it is because insurance companies have skirted compliance with the federal law that states like Hawaii have had to write their own versions of 2706.
In practice, it is Kaiser and other insurers whose response to 2706 has been “inconsistent with federal law” which was written explicitly to end discrimination against licensed care providers of all kinds.