Michigan House Bill HB5973

Michigan 2023-2024 Regular Session

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

Caption

Insurance: health insurers; health care benefits that require certain deductibles or copays; provide for certain restrictions. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406nn.

Impact

The bill is expected to have a significant impact on health insurance providers and their pricing structures. Insurers will be required to reassess their policies to ensure compliance with the new regulation regarding copayment and coinsurance limits. This could lead to more standardized health care benefits across different insurance providers, as the legislation aims to provide a baseline protection for consumers. Additionally, it may reduce financial burdens on individuals seeking necessary health services, potentially leading to increased utilization of health care.

Summary

House Bill 5973 proposes an amendment to the Michigan Insurance Code of 1956, specifically addressing the structure of copayments and coinsurance for health care services. It mandates that health insurance policies may not charge a copayment or coinsurance greater than 50% of the cost of the health care service covered. This requirement seeks to protect insured individuals from excessively high out-of-pocket expenses for health care services. By instituting this maximum limit, the bill aims to enhance affordability and accessibility in health care for Michigan residents.

Contention

However, the introduction of such limits may generate contention among stakeholders. Some health insurers may argue that limiting copayments and coinsurance could decrease their ability to manage costs and could lead to increased premiums for policyholders. Additionally, concerns may arise regarding how these changes might affect the overall health care market dynamics, including service availability and insurance offerings. Advocates for consumer protection may support the bill, while insurers might contest the impact on their operational sustainability and pricing strategies.