Health Insurance Restrictions and Limitations Clarification Act of 2008
HEALTH INSURANCE RESTRICTIONS AND LIMITATIONS CLARIFICATION ACT OF 2008 -- (House of Representatives - September 23, 2008)
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Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in strong support of H.R. 6908, the Health Insurance Source of Injury Clarification Act of 2008. This bill would prohibit health insurers from restricting or denying benefits to plan participants if they are injured while engaging in legal recreational activities like riding a motorcycle, skiing, snowmobiling or horseback riding unless such restrictions were made explicitly clear by the plan to the person before he or she enrolled.
Mr. Speaker, this change is necessary because of a 2001 rule that was issued in accordance with the Health Insurance Portability and Accountability Act of 1996.
While that 1996 rule prohibits employer health plans and insurers from denying coverage to individuals who engage in legal recreational activities, the rule ironically allows the denial of health care benefits for injuries sustained while participating in such recreational activities. If I could explain that again, you can't deny coverage, but you can deny benefits, which obviously makes no sense.
Accordingly, the rule in its current form will allow insurance companies to treat health care benefits coverage arbitrarily and capriciously. Under the current rule, a plan could for example deny coverage for someone who has broken an arm through skiing or riding a motorcycle but would cover someone who sustained a similar injury from drinking and driving. What is worse is that a person might not even know that their health care coverage was even subject to such limitations until after they were actually injured.
So, Mr. Speaker, this is an important consumer protection for millions of Americans who participate in recreational activities every day by providing greater transparency for plan participants. When we enacted the rule in 1996, we did not intend that people would be allowed to purchase health insurance only to find out after the fact that they had no coverage for an injury resulting from a common recreational activity. This bill simply clarifies that point.
I want to thank Mr. Stupak and Dr. Burgess who have worked very hard on this legislation. I urge my colleagues on both sides of the aisle to support its adoption.
I reserve the balance of my time.
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