From: Kathleen Gmeiner

To: E-OHPSCA715.EBSA

Subject: ATTENTION: RIN 1210-AB43 -- Comments on Patient Bill of Rights

Date: Friday, August 27, 2010 3:55:38 PM

August 27, 2010

Secretary Timothy Geithner

Department of the Treasury

Secretary Hilda Solis

Department of Labor

Secretary Kathleen Sebelius

Department of Health and Human Services

Office of Health Plan Standards and Compliance Assistance

Employee Benefits Security Administration

Room N-5653

U.S. Department of Labor

200 Constitution Avenue

NW., Washington D.C. 20210

ATTENTION: RIN 1210-AB43

UHCAN OhioComments on Interim Final Rules for 26 CFR Parts 54 and 602, 29 CFR Part 2590, and

45 CFR Parts 144,146, and 147: Requirements for Group Health Plans and Health Insurance Issuers

Under the Patient Protection and Affordable Care Act Relating to Pre-existing Condition Exclusions,

Lifetime Annual Limits, Rescissions, and Patient Protections

Dear Secretaries Geithner, Solis and Sebelius:

UHCAN Ohio is pleased to have an opportunity to comment on proposed regulations that will

implement what has been referred to as The Patient’s Bill of Rights. We have reviewed the comments

submitted on August 20, 2010 by Community Catalyst (CC) and Health Care for All (HCFA) and

concur in their comments.

http://www.communitycatalyst.org/doc_store/publications/Patients_Bill_of_Rights_Comments_8.20.10.pdf

We would like to add the following with respect to Ohio. Ohio has an administration that is strongly

supportive of health care reform, but Ohio’s legal framework is relatively weak in terms of regulating

the insurance industry. For that reason, we note the particular comments that we find compelling in

relationship to Ohio’s situation:

· We concur with CC’s and HCFA’s urging of the explicit inclusion of all individual health plans

in paragraph (a)(1) of the rules, requiring that children may not be subject to exclusion based on

their pre-existing condition.

· We also concur with CC and HCFA in urging that there be very clear notification of the new

prohibition on exclusion of children to anyone who has been denied coverage due to a pre-
existing condition.

· It is important in Ohio where there is weak regulation that HHS work with states to monitor

the health insurance marketplace to make sure that families can afford coverage. Even with the

existence of a high risk pool in Ohio as the result of the Affordable Care Act, we are finding that

premiums are unaffordable to families due to the premiums, high deductibles and co-pays.

We have great concerns about the limitation on annual caps on benefits being undermined by the

possibility that insurance companies will limit the kinds of benefits available even while complying

with the dollar amount limits. We concur with CC and HCFA’s comments that it should be made

explicit that both dollar volume and service volume fall within the restrictions on annual caps.

UHCAN Ohio also concurs with CC and HCFA’s comment that steps must be taken to ensure that

insurance companies do not shift emergency care costs to consumers when the presenting

condition requires overnight admission for purposes of stabilization. We hear from hundreds of

people each year who have been subjected to significant medical debt, and often that debt starts

with an ER visit. 

Thank you very much for this opportunity to comment.

Sincerely,

Cathy Levine

Executive Director

UHCAN Ohio

Kathleen Gmeiner, JD, MHSA

UHCAN Ohio

Project Director, Ohio Consumers for Health Coverage

370 S. Fifth Street, Suite G3

Columbus, Ohio 43215

(614) 456-0060 ext. 223

kgmeiner@uhcanohio.org