Newly Introduced Bill Would Strengthen Medigaps & Consumer Protections

Newly Introduced Bill Would Strengthen Medigaps & Consumer Protections

Earlier this month, Representative Sandy Levin (D-MI), Ranking Member of the Ways and Means Health Subcommittee, introduced the Medigap Consumer Protection Act of 2018. This legislation would provide a long overdue overhaul on Medigap’s consumer protections, ensuring that all beneficiaries, regardless of their age, disability, or any other pre-existing condition, have ease in accessing information on these plan options and in purchasing them.

The bill would ensure several key reforms that would lower costs and improve the Medicare supplemental coverage market for beneficiaries, especially those with disabilities and/or end stage renal disease.

Specifically, the bill includes the following protections and reforms, as summarized in Rep. Levin’s press release:

  • Strengthen federal consumer protections to ensure that beneficiaries with disabilities and those with end-stage renal disease can purchase a Medigap policy without being denied coverage or subjected to higher premiums based on their health status or pre-existing conditions.
  • Extend protections to other beneficiaries, including individuals in Medicare Advantage plans who wish to switch back to traditional Medicare.
  • Improve plan efficiency by calling for a review of medical loss ratio requirements, which limit the percentage of premium dollars insurers can spend on administration and profits.
  • Call for a review of pricing standards in the Medigap market to prohibit the sale of policies that discriminate based on the age of individuals.
    Require the Secretary of HHS to conduct a comprehensive overhaul of the Plan Finder website to ensure that beneficiaries have access to complete and understandable information when comparing enrollment options.
  • Restore access to the two most popular Medigap policies (Plans C and F), which are set to be eliminated for beneficiaries who enroll in Medicare after January 1, 2020.
  • Improve transparency by requiring issuers to disclose payments to Medigap brokers and agents through the Open Payments database.

While this bill may not get very far this year, especially with Rep. Levin retiring at the year’s end, having it out and on the table is an important way to keep the awareness and pressure up for adopting these needed and long over due consumer protections. For more information, see Representative Levin’s summary of the bill and bill text.

Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.