Texas House Bill HB4218

Texas 2017 - 85th Regular

Caption

Relating to health benefit plan coverage in this state.

Impact

The most notable changes proposed by HB 4218 include prohibitions on discrimination based on gender and requirements for coverage related to mental health and substance use disorders. This aligns Texas law with federal mandates under the Affordable Care Act, which previously established essential health benefits that must be offered. The bill specifically protects individuals with preexisting conditions by barring health benefit issuers from denying coverage or charging higher rates based on those conditions. Lawmakers believe these provisions will provide a more equitable healthcare framework and improve public health outcomes in the state.

Summary

House Bill 4218 addresses broad aspects of health benefit plans in Texas, with a particular focus on affordability and accessibility. This bill amends the Insurance Code to establish requirements for how health benefit issuers cover a range of medical expenses. Among its key provisions, the bill stipulates that health benefit plans may not impose certain cost-sharing measures for preventive services and outlines that limitations on such coverage must adhere to federal standards. As such, the legislation aims to enhance the availability of essential health benefits for residents of Texas, ensuring they are not financially burdened when seeking preventive care.

Contention

Despite support for the bill's intent, discussions around HB 4218 reveal contention regarding the financial implications for insurance providers. Some stakeholders express concern that these regulations could lead to increased premiums as insurers adjust to comply with the new requirements. Additionally, there are worries about potential unintended consequences for plan offerings, including the risk that some insurers may opt to withdraw from the market. Critics argue that while the bill aims for increased access and affordability, it may inadvertently diminish competition and consumer choice in health insurance options.