Bill Summary – FastDemocracy

OHIO LEGISLATIVE SERVICE COMMISSION
                                              Office of Research                        Legislative Budget
         www.lsc.ohio.gov                       and Drafting                                  Office
                            H.B. 400                               Bill Analysis
                  135th   General Assembly
Version: As Introduced
Primary Sponsors: Reps. Callender and Sweeney
Effective date:
Nick Thomas, Research Analyst
                                                         SUMMARY
                    Requires, starting January 1, 2025, health plan issuers that offer Medicare supplement
                          policies to individuals age 65 and over, to offer those same policies to individuals who
                          are younger than 65 and who are otherwise eligible for Medicare.
                    Specifies that such policies must be offered on the same terms as those policies offered
                          to individuals age 65 and older.
                    Requires the premiums for policies offered to individuals younger than 65 to be no more
                          than the premiums for policies offered individuals who are 65 years of age.
                    Prohibits such Medicare supplement policies from including preexisting condition
                          exclusions.
                    Requires health plan issuers to offer a special enrollment period for such policies
                          beginning January 1, 2025, and ending July 1, 2025.
                    Allows persons under 65 who are enrolled in a policy issued under the bill to, within
                          60 days of the person’s birthday, acquire a new Medicare supplement policy from a
                          different issuer offering the same coverage.
                                                DETAILED ANALYSIS
Overview
        The bill requires, starting January 1, 2025, health plan issuers that offer Medicare
supplement policies to persons age 65 and older to offer such supplemental plans to individuals
who are eligible for Medicare, but are age 64 or younger. Medicare is health insurance provided
by the federal government. It is offered to individuals who are age 65 or older and also to
individuals who are disabled or suffering from end-stage renal disease or amyotrophic lateral
sclerosis, commonly referred to as ALS. Medicare does not provide coverage for every health
condition that might come up and also can require substantial cost sharing on the part of
                                                                                                        April 9, 2024
Office of Research and Drafting                LSC                            Legislative Budget Office
beneficiaries. Private insurers offer supplemental policies to cover these gaps in coverage.
However, not every state requires their insurers to offer these supplemental Medicare policies
to Medicare-eligible individuals under age 65. Ohio is one such state.
Requirements
        The bill requires health plan issuers to offer Medicare supplement policies to Medicare-
eligible individuals who are under age 65. It also imposes several restrictions in how such
policies are offered. First, the bill specifies that such policies much be offered on the same
terms as those Medicare supplement policies offered to individuals age 65 and older. Any
benefit, protection, policy, or procedure applicable to a plan for an individual age 65 or older
must apply to Medicare supplement plans provided to individuals age 64 and younger.1 The bill
specifies that the premiums for coverage provided to individuals under 65 years of age and
must be the same as the premiums for coverage provided to individuals who are 65 years of
age.2
Existing legal requirements
          For plans issued to individuals under age 65 years, plan issuers must follow all existing
laws pertaining to Medicare supplement policies. These laws touch on topics such as
duplication of benefits, probationary periods, recurrent conditions, and others. The one
exception to this is preexisting conditions exclusions. Current law allows Medicare supplement
policies to exclude coverage for preexisting conditions up to six months after the policy has
been issued.3 The bill prohibits any preexisting condition exclusions in policies issued under the
bill.4 In other words, Medicare supplement policies issued to individuals over 65 could include a
six month preexisting condition exclusion, whereas policies issued to individuals under 65 could
not.
Special enrollment periods
        The bill requires health plan issuers to offer a special enrollment period for policies
issued under the bill. The period runs from January 1, 2025, to July 1, 2025. During this period,
any eligible person would be able to enroll in a policy offered under the bill. 5 Additionally, the
bill enables Medicare-eligible individuals who are under 65 years old, within 60 days of their
birthday each year, to acquire a new Medicare supplement policy offering the same coverage
as the person’s existing policy from a different issuer.6
1   R.C. 3923.3310(A) and (B).
2   R.C. 3923.3310(C).
3   R.C. 3923.332(B), not in the bill.
4   R.C. 3923.3310(D).
5   R.C. 3923.3310(E).
6   R.C. 3923.3310(F).
P a g e |2                                                                                   H.B. 400
                                                                                        As Introduced
Office of Research and Drafting         LSC                 Legislative Budget Office
                                      HISTORY
                             Action                        Date
Introduced                                      02-05-24
ANHB0400IN-135/ts
P a g e |3                                                                 H.B. 400
                                                                      As Introduced