Out of Pocket Protection – Affordable Health Care

It has recently been reported that a little-noticed rule on the U.S. Department of Labors’ website since February would allow many group health plans to maintain separate out-of-pocket limits for medical and prescription drug coverage for 2014.

But according to a report in the Sacramento Business Journal, California may be in the lead on health care reform again. The Assembly Health Committee passed legislation in August to implement consumer protections in the Affordable Care Act against high out-of-pocket costs.

Senate Bill 639 by Sen. Ed Hernandez would implement key protections to provide a one-year delay for some plans if passed by the Legislature this year and signed by the Governor, despite a decision by the Obama administration.

““With this bill, California can once again not just implement the federal law, but improve upon it so our patients get these benefits as soon as possible,”” Anthony Wright, executive director of Health Access, said in a news release.

“This bill ensures that no California consumer in individual or small group coverage has to wait to get these important consumer protections.”

SB 639 would limit annual out-of-pocket costs to $6,350 per individual.

“”California has been implementing other pieces of the legislation early and should be in a place to go ahead on this,”” Wright said. “It is possible the question is moot in California because benefits and out-of-pocket costs are already set by Covered California for 2014,” he added.

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