Does Obamacare Require Health Insurers to Present Health Insurance Information in Clear and Easily Understandable Terms? – YES
General Reference (not clearly pro or con)
The Patient Protection and Affordable Care Act, Section 2715, page 14, “Development and Utilization of Uniform Explanation of Coverage Documents and Standardized Definitions,” signed into law on Mar. 23, 2010, available at the Library of Congress website, states:
“(a) IN GENERAL.—Not later than 12 months after the date of enactment of the Patient Protection and Affordable Care Act, the Secretary shall develop standards for use by a group health plan and a health insurance issuer offering group or individual health insurance coverage, in compiling and providing to applicants, enrollees, and policyholders or certificate holders a summary of benefits and coverage explanation that accurately describes the benefits and coverage under the applicable plan or coverage…
(b) REQUIREMENTS.—The standards for the summary of benefits and coverage developed under subsection (a) shall provide for the following:
(1) APPEARANCE.—The standards shall ensure that the summary of benefits and coverage is presented in a uniform format that does not exceed 4 pages in length and does not include print smaller than 12-point font.
(2) LANGUAGE.—The standards shall ensure that the summary is presented in a culturally and linguistically appropriate manner and utilizes terminology understandable by the average plan enrollee.”
Mar. 23, 2010 - Patient Protection and Affordable Care Act (HR 3590)
PRO (yes)
Pro
The US Department of Health and Human Services stated its Aug. 17, 2011 article “Providing Clear and Consistent Information to Consumers About Their Health Insurance Coverage,” available at the Affordable Care Act website:
“Under section 2715 of the Public Health Service Act, created by section 1001 of the Affordable Care Act and implemented in the new rules announced today, health insurers and group health plans will provide clear, consistent and comparable information about health plan benefits and coverage to the millions of Americans with private health coverage. Specifically, the rules ensure consumers receive two key forms that will help them understand and evaluate their health insurance choices:
- A short, easy-to-understand Summary of Benefits and Coverage (or ‘SBC’); and
A list of definitions (called the ‘Uniform Glossary’) that explains terms commonly used in health insurance coverage such as ‘deductible’ and ‘co-payment.'”
Pro
Blue Shield of California stated in its Feb. 9, 2012 “Recent News,” available at its website:
“The ACA requires that all health carriers use standard definitions and terms provided by HHS to create uniform explanation of coverage documents. These new documents are intended to enable consumers to more easily understand the coverage they already have and help them make ‘apples-to-apples’ comparisons of available options when purchasing new coverage.”
CON (no)
Con
[Editor’s Note: Based upon a neutral reading of the Patient Protection and Affordable Care Act and bi-partisan third party analysis, this question seems to have a clear and obvious Pro (yes) answer, and ProCon.org has therefore presented the responses in a single column with no opposing perspective.]
