Connecticut House Bill HB06871

Connecticut 2025 Regular Session

• Introduced: 2/6/25
• Refer: 2/6/25
• Report Pass: 3/11/25
• Refer: 3/21/25
• Report Pass: 3/27/25
• Refer: 4/29/25
• Report Pass: 5/5/25

Caption

An Act Limiting Out-of-network Health Care Costs.

Impact

The enactment of HB 06871 is expected to significantly alter the landscape of health care financing in Connecticut. By capping out-of-network charges, the bill addresses concerns regarding exorbitant medical costs that patients often face when accessing services outside their health insurance networks. This move is anticipated to encourage more fair pricing practices among healthcare providers, which could lead to broader accessibility to necessary medical services for residents. Additionally, the Office of Health Strategy will be tasked with monitoring compliance and trends related to cost assessments and provider payments.

Summary

House Bill 06871 is intended to limit out-of-network health care costs for patients covered by health benefit plans in Connecticut. The bill stipulates that the out-of-network costs assessed by health care providers for hospital services cannot exceed 240% of the Medicare reimbursement rate for similar services within the same geographic area. This proposed legislation aims to provide transparency and financial predictability for patients seeking care outside of their insurance networks, with implementation set for January 1, 2026.

Sentiment

Sentiment regarding HB 06871 is mixed among various stakeholders. Proponents, mainly patient advocacy groups and some legislators, view the bill favorably, arguing it will protect consumers from surprise medical bills and enhance affordability in healthcare. On the other hand, opponents, including certain health care providers and insurance companies, express concern that the bill may undercut the revenue necessary for providing a variety of services and potentially lead to reduced access to specialty care as providers adjust to tighter price limits.

Contention

Notably, key points of contention include the potential implications for healthcare providers, who may find it challenging to sustain their operations with the reduced reimbursement rates dictated by the bill. Rural hospitals and federally qualified health centers may also be adversely affected, as the bill excludes them from the new rate limits, raising concerns about fairness and equity in treatment across urban and rural healthcare markets. These concerns highlight the ongoing tension between ensuring affordable healthcare costs for consumers and maintaining robust health service provision.