In the absence of action by their own state health insurance regulators to push health insurer compliance with Section 2706 of the ACA, some state lawmakers are introducing legislation that borrows directly from Section 2706 in order to remove discrimination against integrative and other licensed healthcare professionals in their states.
Lawmakers in both New Mexico and Rhode Island introduced legislation this month into their respective legislatures. New Mexico Democratic state senator Mary Kay Papen introduced S-190, and in Rhode Island, Democratic representative Joseph McNamara introduced H-5046.
Both these bills embody the intent of and quote directly from the language of Section 2706. As written in the Rhode Island bill:
“This act would prohibit a group health plan and a health insurance issuer from discriminating with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable state law.”
The New Mexico bill would remove from its statutes previously adopted measures crafted for specific specialties such as chiropractic and acupuncture, since S-190 adopts the 2706 prohibition against excluding any licensed provider.
At this time neither bill includes any penalties or remedies for non-compliance, a feature that is being considered in other states’ initiatives. The absence of enforcement measures has been considered a shortcoming of Section 2706 since its adoption.
It is not yet clear how the bills will fare during these states’ legislative sessions, but they do reflect strong interest these two states (others are also developing similar language) to end the discrimination that licensed providers have faced historically. When properly adopted by the insurers, these provisions will open access to integrative providers on an equitable financial basis, which has long restricted use of most integrative therapies to those who can afford to pay for them out of pocket.
There will be more development on state-based action in 2015.