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Rep. McDermott Bill to Make Health Insurance Companies Accountable For Denied Benefits

October 27, 2009

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For the first time, legislation (HR 3925) introduced by Rep. Jim McDermott (D-WA) would provide every American who is enrolled in an employer-sponsored health care plan with the ability to seek recourse if a health care benefit is improperly denied by their health insurance company.

“Every American who receives health care insurance through their employer is vulnerable today, while every health insurance company is insulated from accountability when a mistake is made that harms someone” Rep. McDermott said, “That’s unfair and wrong and it is time an injustice that grossly benefits the insurance industry ends.”

The 1974 ERISA legislation (Employee Retirement Income Security Act) essentially exempts health care insurance companies from accountability for anyone enrolled in a health insurance plan through work, which is where the majority of Americans obtain their health insurance today.

“This is a deliverable we ought to deliver to the American people as part of our commitment to comprehensive health care reform,” Rep. McDermott said.

The Seattle congressman explained that his home State of Washington is among several states that have laws on the books to permit action against a health insurance company, but the laws often cannot be enforced because of conflict with the federal ERISA law, which preempts the state law and renders it unenforceable.

“This is a case where states have no rights to protect their residents and consumers have no protection in the health insurance marketplace, and this is something that Congress can remedy immediately in health care reform legislation,” Rep. McDermott said.

Throughout the health care debate there has been much discussion over the role and costs associated with health care insurance companies.  As part of his leadership on the House Ways and Means Committee, McDermott said he has been researching the infrastructure and delivery system and the ERISA legislation surfaced as an area that needs immediate reform.

“This cuts to the heart of the issue, cost,” McDermott said.  He explains:  “If people are denied health care benefits to which they are entitled and have paid for, the harm that comes to them ripples through the system in higher costs as health care needs go untreated.”

McDermott said he will urge House and Senate leaders to quickly pass his legislation or incorporate it into overall health care reform legislation.

 

 

 

 


 


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