[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. Con. Res. 32 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
S. CON. RES. 32

  Expressing the sense of Congress on health care reform legislation.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 25, 2009

 Mr. Menendez submitted the following concurrent resolution; which was 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                         CONCURRENT RESOLUTION


 
  Expressing the sense of Congress on health care reform legislation.

Whereas consumers may continue to confront a variety of problems with a reformed 
        health care system;
Whereas those problems may range from difficulties in choosing an appropriate 
        health plan, problems with calculation of premiums and cost-sharing, the 
        possibility of a denial of benefits, and issues with enrollment and 
        access to providers;
Whereas the Institute of Medicine estimates that as many as 30 percent of people 
        in the United States suffer from health treatment illiteracy;
Whereas the Office of Disease Prevention and Health Promotion of the Department 
        of Health and Human Services reports that only 12 percent of the 
        population can use a table to calculate the share of health insurance 
        costs for an individual;
Whereas a study by RAND Corporation found that increasing the ease of access to 
        information regarding insurance products and simplifying the application 
        process would increase purchase rates of insurance products as much as 
        modest subsidies would;
Whereas the reports from the Institute of Medicine, the Office of Disease 
        Prevention and Health Promotion, and RAND Corporation prove there is a 
        need for a fundamental improvement in the manner in which consumers 
        learn about insurance choices;
Whereas many consumers lack avenues or mechanisms to present grievances both to 
        the managers of health plans and to external reviewers and fail to 
        receive timely decisions with respect to those grievances;
Whereas consumers often need expert guidance to pursue claims for denied health 
        care benefits and other coverage disputes;
Whereas some States have documented a number of cases of improperly rescinded 
        health insurance policies, inappropriate billing for out-of-network 
        services, and fraudulent and deceptive marketing of health plans;
Whereas the Federal Government lacks oversight mechanisms to prevent health care 
        coverage problems from recurring in other States;
Whereas the appropriate resolution of a health coverage complaint may involve 
        multiple Federal and State agencies;
Whereas health plans sometimes make mid-year changes to provider networks, 
        benefit offerings, or other elements of the plan important to enrollees;
Whereas people need assistance enforcing consumer rights in the health care 
        system; and
Whereas Federal laws have created successful models of consumer assistance with 
        health dispute resolution, such as the Long Term Care Ombudsman program 
        that assists nursing home residents in every State and the Senior Health 
        Insurance Assistance Program that assists those eligible for Medicare: 
        Now, therefore, be it
    Resolved by the Senate (the House of Representatives concurring), 
That it is the sense of Congress that any health care reform 
legislation should include, with respect to health plans--
            (1) support for consumer education and assistance with 
        enrollment, particularly for vulnerable populations, at both 
        the Federal and State levels;
            (2) assistance for people asserting consumer rights;
            (3) a strengthened system of consumer protections, 
        including--
                    (A) an appeal mechanism within a health plan, and 
                an appeal mechanism with an external entity independent 
                of the health plan, which could address a variety of 
                coverage problems;
                    (B) coverage for emergency care without prior 
                authorization;
                    (C) protections against balance billing in 
                emergency situations and in situations in which in-
                network providers are unavailable;
                    (D) protections against mid-year health plan 
                changes that could have an impact on the cost-sharing 
                or access to services of an enrollee;
                    (E) verification of accurate out-of-network co-
                payment charges; and
                    (F) protections against misleading marketing; and
            (4) a strengthened enforcement system of consumer rights 
        for claims, with respect to health plans, involving systemic 
        violations of consumer protections, including remedies for 
        individuals, civil penalties, and other appropriate sanctions.
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