NJ lawmaker: Give people medical insurance bills they can actually read
It can be a cold, confusing world sometimes, but Assembly Minority Leader Jon Bramnick says the path to fix that starts with "explanation of benefits" forms from health insurance companies.
“I understand that that’s not the cause for frustration in society, but it’s a cumulative effect when people are frustrated with stuff they get in the mail,” Bramnick said.
“The reason this bugs me so much is because I find that society more and more is making it more difficult, more confusing and more frustrating for the consumer. And I think we have an obligation to make it clear, simple and easy. And I guarantee you it can be done,” he said.
Bramnick, R-Union, says the letters are unnecessarily complicated – written in legalese, peppered with codes and irrelevant information. He wants insurers to use plain language to tell people if their medical bills are covered. He's hoping the companies will do this either voluntarily or through a law he'll propose.
“I spoke to the insurance companies, and they’re willing to sit down and talk to me,” Bramnick said. “I’m a Republican. If I don’t have to mandate this, I won’t do it. But I probably will have to mandate it.”
A 1979 state law, the Life and Health Insurance Policy Language Simplification Act, says the EOB notices people get in their mail from their health insurers are supposed to be easy to read. Bramnick says they’re anything but.
“The bill that I intend to file is going to say that in 12-point print, when they tell you they’re not paying the bill, they tell you why. And they put it in plain language,” Bramnick said.
“I just think it’s time for us to speak up and say, hey, let’s make it consumer-friendly, not insurance-friendly,” he said.
The idea isn’t new – and an alternate version has been opposed by Bramnick’s fellow Republicans.
Last month, the Assembly insurance committee voted for the third time to require insurers to use standard EOB forms developed by the state Department of Banking and Insurance, intended to be easier to follow and understand. The versions of that plan that passed in 2014 and 2016 were opposed by all of the committee’s GOP members.
Neither of those bills, nor one that advanced in 2005, were posted by the speaker for votes by the full Assembly. The version that advanced last month, A2140, could still be considered by the full Assembly.
Bramnick is an attorney and said insurance companies may have made the EOB forms more complex because it’s a litigious society. And he conceded he’s not an ally of the insurance companies because of his private-sector experience.
“Do you think the fact that I’m a plaintiff’s lawyer, that I have some bias against the insurance companies? Probably,” he said. “If you’re on that same side for 40 years of fighting with insurance companies, sure … But it doesn’t make my observations somehow skewed with respect to this issue.”