Only 15 states have passed laws establishing an independent external appeals process for consumers who believe they have been wrongfully denied care. Of the 13 key protections studied, the establishment of independent consumer assistance programs and changes in liability laws had been passed by the fewest states. Vermont is the first and only state to pass a law that provides funding for an independent statewide consumer assistance program. Two states, Texas and Missouri, passed laws that open the door so that consumers can hold their health plans accountable through litigation. This issue is still being debated in the courts.
Health plans have no accountability for their decisions to deny needed care and treatment.
This lack of meaningful remedies invites abuse. Current proposals in Congress address many of the protections studies in the new Families USA report. The Patients' Bill of Rights introduced by Senators Daschle and Kennedy and Representatives Dingell and Gephardt would establish all 13 of the protections studied. The House Republican proposal, which is not yet in legislative form, would address from two to four of the issues. Federal protections are needed to ensure all Americans get fair treatment from their managed care plans.