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01/28/2020 04:28 AM
Pennsylvania State Senate
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=S&SPick=20190&cosponId=30512
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Senate of Pennsylvania
Session of 2019 - 2020 Regular Session

MEMORANDUM

Posted: October 11, 2019 11:03 AM
From: Senator Pam Iovino and Sen. Vincent J. Hughes
To: All Senate members
Subject: Prohibiting Annual or Lifetime Limits on Health Insurance Policies
 
In the near future, we plan on introducing legislation to prohibit health insurance policies within the Commonwealth from imposing either an annual or lifetime limit.

Prior to the passage of the Affordable Care Act (ACA), health insurance companies could impose annual or lifetime limits on coverage for health insurance policies. It is estimated that prior to the federal prohibition on annual and lifetime limits, nearly 102 million Americans nationwide had a health insurance policy that was subject to either an annual or lifetime limit. Once these limits were reached, a policy holder or their family would be required to pay 100% of medical expenses out of pocket. This saddled individuals and families with debt and forced some to declare bankruptcy.

Annual or lifetime limits typically affect individuals with chronic medical conditions, such as cancer, mental illness, or addiction, that require constant treatment and drug therapies. According to estimates from the Departments of Human Services and Insurance, 4.5 million Pennsylvanians have benefited from the Federal prohibition on annual and lifetime limits.

Currently, several cases are pending before appeals courts across the country that threaten these federal protections. The most pressing case is currently with the U.S. Court of Appeals 5th Circuit which is reviewing a lower court’s decision that found the ACA unconstitutional. If the Court of Appeals were to affirm the lower court’s findings, the protections provided by the ACA relating to annual or lifetime limit prohibitions would be lost because Pennsylvania law does not currently prohibit the sale of an insurance policy carrying an annual or lifetime limit.

Under our legislation, insurance policies sold or renewed in the Commonwealth, after the effective date of the bill, may not include an annual or lifetime limit.

Please join us in ensuring Pennsylvania law provides this important protection for our residents in the event the ACA is overturned through judicial means.



Introduced as SB939