2015 has been a season for testing the proposition that if a Federal law isn’t quite getting the attention of the people it is directed to, bring it to the states.
In the case of Section 2706 of the ACA, advocates from the licensed professions whose work is not reimbursed by insurance have been creating bills for their own state legislatures to consider, borrowing directly from the language of 2706.
In two cases – Oregon (May) and Rhode Island (July) – the bills have been signed into law.
In Hawaii and California very similar 2706-like bills were introduced and moved expeditiously through the committee process, only to be referred over to the 2016 session. In Minnesota, a multi-discipline practitioner group created language for a bill at the end of 2014. This team decided not to introduce it this year, choosing instead to focus on grass roots advocacy work in the fall and winter to prepare for introducing its legislature in 2016.
As can be expected, each of these first bills based on 2706 has its own twists on implementation. Oregon includes provisions for insurers to report annualy to the state how well they are including licensed integrative providers in their networks. But the bill doesn’t go into effect until 2017; a concession to the insurers.
Rhode Island’s bill went into effect the day it was signed in July. But its provisions do not contain similar provisions obliging insurer reports.
Both these bills also lack specific enforcement measures or penalties, which also replicates the original design of Section 2706. It is uncertain at this writing if the states bringing legislation forward in 2016 will include enforcement provisions or other obligations on the companies.
But the passage of these bills is significant, as they bring the focus for ending discrimination against licensed healthcare providers directly into the purview of the state insurance commissioners who also license the companies that sell and service health insurance policies, for individuals and for employers.
Following the lead of the Minnesota group, IHPCs CoverMyCare program is teaming up with other organizations this fall, including the Academy for Integrative Health & Medicine and the America Sustainable Business Council, ABSC, to aggregate the interest of patients, providers, and payers who will benefit from the proper implementation of Sect 2706. Through either clearer federal direction, or from state-based advocacy efforts that will — at worst — reflect that market imbalance between widespread public use of integrative therapies and the lack of reimbursement for them, the original purpose of Section 2706 is likely to continue to gather strength.
For a Summary on State Developments, see CoverMyCare’s update here.