Vote Smart's Synopsis:

Vote to pass a bill that establishes the permanence of certain consumer protections under the Affordable Care Act.

Highlights:

• Specifies that the following provisions of the Affordable Care Act shall apply to state individual health insurance coverage and health insurance coverage offered in small and large group markets, including (Subtitle 1A, Sec. 15):

• Coverage for children up to the age of 26;

• Preexisting condition exclusions and policy rescissions;

• Bonafide wellness programs and lifetime limits;

• Annual limits for essential benefits and waiting periods;

• Designation of primary care providers;

• Access to obstetrical and gynecological services;

• Emergency services and summary of benefits and coverage explanations;

• Minimum loss ratio requirements ad premium rebates;

• Disclosure of information and annual limitations of cost-sharing;

• Child-only plan offerings in the individual market;

• Minimum benefit requirements for catastrophic plans;

• Health insurance premium rates;

• Coverage for individuals participating in approved clinical trials;

• Contract requirements for stand-alone dental plans sold on the Maryland Health Benefit Exchange;

• Guaranteed availability of coverage and prescription drug benefit requirements; and

• Preventative and wellness services and chronic disease management.

• Prohibits a carrier from doing any of the following, including (Subtitle 1A, Sec. 15):

• Excluding or limiting benefits because a health condition was present before or on the date of denial; or

• Denying coverage because a health condition was present before or on the date of denial.

• Specifies that the above-mentioned provision shall apply whether or not any medical device, diagnosis, care, or treatment was recommended or received for the condition or the health condition was identified as a result of (Subtitle 1A, Sec. 15):

• A pre-enrollment questionnaire or physical examination given to an individual; or

• A review of the records relating to the pre-enrollment period.

• Prohibits a carrier from establishing rules for eligibility, including continued eligibility, for enrollment of an individual into a health benefit plan based on health status-related factors, including (Subtitle 1A, Sec. 15):

• Health conditions;

• Claims experience;

• Receipt of health care;

• Medical history;

• Genetic information;

• Evidence of insurability including conditions arising out of acts of domestic violence; or

• Disability.

• Prohibits a carrier from requiring an individual to pay a premium rate as a condition of enrollment or controlled enrollment in a health benefit plan (Subtitle 1A, Sec. 15).

• Defines “carrier” to as the following, including (Subtitle 1A, Sec. 15):

• An insurer that holds a certificate of authority in the state and provides health insurance in the state;

• A health maintenance organization that is licensed to operate in the state;

• A nonprofit health service plan that is licensed to operate in the state; and

• Any other person or organization that provides health benefit plans subject to state insurance regulations.

Full Bill Text