The Health Coverage Across State Lines Act would allow health insurance companies to sell individual policies across state lines by designating a single "primary state" whose regulations govern the policy, while largely exempting insurers from the insurance rules of "secondary states" where coverage is sold—though secondary states would retain limited authority over taxes, licensing, fraud compliance, and claims handling. The bill aims to reduce health insurance costs by reducing regulatory burden and increasing competition, and it includes consumer protections requiring insurers to disclose that cross-state policies may not comply with all local insurance laws, prohibiting premium increases or reclassification based on health status at renewal, and establishing independent medical review processes for claim denials. Insurers would need to obtain state licenses, submit financial documents to state insurance commissioners, and can only operate in secondary states if they already offer coverage in their primary state and that state uses risk-based capital requirements. The bill grants primary states sole enforcement authority and directs the Government Accountability Office to conduct a five-year study tracking the law's effects on insurance coverage, costs, and fraud.
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