[Congressional Record (Bound Edition), Volume 155 (2009), Part 12]
[Senate]
[Page 16275]
[From the U.S. Government Publishing Office, www.gpo.gov]




    SENATE CONCURRENT RESOLUTION 32--A BILL EXPRESSING THE SENSE OF 
               CONGRESS ON HEALTH CARE REFORM LEGISLATION

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

                            S. Con. Res. 32

       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     improperly rescinded health insurance policies, inappropriate 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;

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