Senate Bill 50 would enshrine in state law a prohibition on health insurance companies from using an individual’s pre-existing medical condition to deny or exclude coverage under a health insurance policy. This legislation was developed in partnership with the Pennsylvania Insurance Department.

Several states have sought and been approved for a waiver from this requirement and have begun selling insurance policies on the ACA marketplace that deny coverage to individuals with preexisting conditions. According to information from the Insurance Department, up to 5.4 million people in the Commonwealth have a pre-existing condition.

Our legislation would amend the Insurance Company Law to prohibit health insurance companies from denying or excluding coverage based on an individual’s preexisting medical conditions. In the past, this legislation has enjoyed bipartisan support.

Senate Bill 51 which proposes codifying the federal essential health benefits (EHB) into state law. Before the ACA imposed EHB, three in five people had an insurance policy that did not provide maternity coverage and one in three policies did not cover substance abuse treatment. This legislation was developed in partnership with the Pennsylvania Insurance Department.

Under our proposal, the ten essential health benefits (EHB) currently covered by the ACA would be placed into state law. The benefits our legislation would cover includes: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.