Bill > SB50

This bill, known as the Health Insurance Access Protection Act, establishes comprehensive protections for health insurance consumers in Pennsylvania by prohibiting insurers from discriminating against individuals based on pre-existing conditions or health factors. The bill prevents insurers from denying coverage, charging higher premiums, or excluding benefits for individuals in both individual and group health insurance markets due to their health status. It limits premium rating factors to only four categories: family size, geographic rating area, age (with a maximum 3:1 variation), and tobacco use (with a maximum 1.5:1 variation). The bill requires insurers to create single risk pools for individual and small group markets, ensuring that the cost of insurance is more evenly distributed. It grants the Insurance Department authority to regulate these provisions, including defining geographic rating areas and age bands. The bill also establishes significant enforcement mechanisms, allowing the Insurance Commissioner to impose penalties for violations, including fines up to $5,000 per violation (or $10,000 for willful violations), license suspension, or license renewal denial. These protections align with and complement federal Affordable Care Act requirements, aiming to make health insurance more accessible and equitable for Pennsylvania residents.