Michigan House Bill HB5971

Michigan 2023-2024 Regular Session

• Introduced: 9/26/24
• Refer: 9/26/24

Caption

Insurance: health benefits; health care benefits that require certain deductibles or copays; provide for certain restrictions on whether health care service can be listed as a health care benefit. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406jj.

Impact

If enacted, this bill could significantly impact health care affordability for Michigan residents. By restricting high-cost sharing for covered health services, HB5971 seeks to alleviate financial burdens on policyholders, ensuring that necessary health services remain accessible. This adjustment is expected to influence health insurance market practices by compelling insurers to reevaluate their policies and coverage options, particularly concerning the structuring of copayments and deductibles. Consequently, health insurance providers may need to adopt more consumer-friendly pricing models, fostering a better alignment of coverage with affordability.

Summary

House Bill 5971 amends the Michigan Insurance Code of 1956 by introducing section 3406jj, which places restrictions on health insurance policies regarding the coverage of healthcare services with high copayment or coinsurance costs. Specifically, the bill prohibits insurers from including a health care service as a covered benefit if the copayment or coinsurance required from the insured exceeds 50% of the overall cost of that service. This legislative change aims to enhance consumer protection by ensuring that individuals are not subjected to prohibitively high out-of-pocket expenses for essential health services.

Contention

Noteworthy points of contention surrounding HB5971 include concerns regarding its potential impact on the insurance market dynamics. Opponents may argue that imposing such limits on cost-sharing could unintentionally drive up premiums for consumers, as insurers might adjust their rates to compensate for the increased obligation to cover more healthcare costs. Additionally, some stakeholders might contend that the bill could restrict insurers' ability to offer a diverse range of plans tailored to varying consumer needs, particularly if the requirement to limit copayments diminishes the flexibility to design specialty plans for different demographics.