Health Plan Suits May Raise Premiums

April 26, 2001 (PLANSPONSOR.com) - The latest plan for giving patients the right to sue their health plans could increase the typical yearly insurance premium by 4.2%, or roughly $100, Congressional budget analysts say.

Sen. Edward Kennedy (D-Mass.) a supporter of the legislation, said the estimate proved that the cost of helping patients is very affordable.

Current laws send such cases to the federal courts, however the new legislation would send most cases to state courts, where damage awards are typically larger.

The new plan has been opposed by the White House, which wants all cases directed to federal court and lower caps on damages citing simpler procedures for employers with business in multiple states.

According to the Associated Press, the rise in premiums would result from what it costs insurance companies to comply with the patient rights proposal, which allows Americans to sue their HMOs for denial of care.

If passed, the bill would force insurers to pay for emergency room treatments, access to specialists, visits to obstetrician-gynecologists, and health care for patients in clinical trials.

CBO estimates that if HMOs pass the cost of complying with the legislation to consumers, the premium impact would be increases averaging less than 1% a year for the next five years. 

Currently, the average annual premium for health plans provided to American workers is about $2,000. Kennedy estimates that once the bill is passed, the monthly cost would increase by under $2.20.

Meanwhile, a survey conducted by the Blue Cross and Blue Shield Association (BCBSA) showed that the right to sue is regarded as a top priority by only 1% of those polled,  with affordable health care being the priority for most.

– Andrew MacDonald     editors@plansponsor.com

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