State Non-Discrimination Laws

There’s a good bit of linguistic gymnastics going on when it comes to interpreting Section 2706:

A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.

What kind of health care provider does Section 2706 apply to? Any kind. By not specifying provider types, the ACA intended to create an all-inclusive umbrella of coverage, so that no provider type would be unintentionally left out. Sounds nice, right? Unfortunately, this non-specific language is allowing insurance companies to continue its discrimination.

That’s what makes the most recent news out of Hawaii so frustrating. Some background: This state is one of a few states (also including New Mexico and Rhode Island) that has been drafting their own version of Section 2706. By making the language of Section 2706 into state law, these states are telling insurance companies that this section of the ACA is important and must be followed.

Last month in Hawaii, the state senate reviewed the language of the bill and decided to rework it to focus support specifically on naturopathic doctors.

Why just naturopaths? Hawaii already has strong insurance coverage for chiropractic and acupuncture; naturopathic medicine needs more protection against discrimination. And so, by specifying that insurance companies cannot discriminate against “naturopathic physicians acting within their scope of practice”, the law gets done what Section 2706 has had trouble doing, albeit for just one provider type. But one provider type is certainly better than none.

Recent news, however, shows just how tight of a grip the insurance companies have on lawmakers. The bill that had been reformulated to protect naturopaths has been amended yet again back to its original focus, the more general protection of “all licensed care providers”.

And, sure, that might sound great – everyone gets covered, right? Not just naturopaths, but also massage therapists. A win for us, surely?

But protection for “any health care provider” is already the exact language of Section 2706, and insurance companies are fighting hand-over-fist to allow continued discrimination. And considering that this change was in part due to requests by Kaiser Permanente, I think the insurance companies know exactly what they’re doing.


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