Oregon and Section 2706

I thought that Oregon would be ahead of the game when it came to the Affordable Care Act roll-out, especially as it pertains to CAM providers. The state already issues licenses for most types of CAM practitioners (notably, massage therapists and naturopaths), which means that they understand the necessity of having a diverse range of medical providers available for treatment. Surely, they’d be on board with Section 2706, the provision that makes it illegal for insurance companies to pick and choose the types of providers they cover.

But then the Exchange opened. By and large, the policies being offered there (which, by their very existence, needed to conform to the rules outlined in the ACA) did not offer CAM of any kind. Only the policies at the very top – platinum plans as well as a few gold plans – covered naturopathic, chiropractic, and acupuncture.

Massage? Don’t even bother asking. Massage coverage wasn’t a category on the Cover Oregon website at all, due to the fact that zero plans on the exchange offered it.

Wait, it gets worse: Many insurance policies that weren’t from the exchange (ie, plans available through employers) were changing in January – ostensibly to fall more in-line with ACA regulations. For at least a few of these plans, these changes included the removal of previous CAM coverage. Definitely not in compliance with the new regulations, but who was going to argue?

Well, plenty of people were going to argue. But who was going to listen or do anything about it? Passing a new law is easy compared to the cumbersome task of actually enforcing it.

Since the Exchange began in October, the Oregon’s insurance commissioner has received an earful of complaints, from groups like the local naturopathic and chiropractic associations, as well as from our local AMTA chapter. Progress has been slow.

When I personally emailed the commissioner’s office in November, I was told the following: “The Oregon Department of Justice is currently reviewing draft guidance on Section 2706(a) of the Public Health Service Act that was drafted by the division. We hope to issue final guidance later this month.” Will the ODOJ interpret the law as it was originally intended? What will that mean for the thousands of policies already in force that discriminate against providers?

It’s now January – the Exchange plans have started, the Affordable Care Act is fully active – and there still hasn’t been any word. The insurance commissioner met with the Oregon House Committee on Healthcare last week, and she assured them that guidelines would be issued by the end of the this month. Now that she has to answer to the legislature, she’ll hopefully be held to her promise. Naturally, I’ll update the blog as soon as I hear anything.