* 39 states have failed to act on insurance reforms
* Inactive states could lose regulatory authority to U.S.
WASHINGTON Feb 1 Only 11 of the 50 U.S. states
have moved to implement new consumer safeguards under President
Barack Obama's healthcare law, raising questions about how major
health insurance reforms will be enforced, a report released on
The report by the nonpartisan Commonwealth Fund found 39
states have yet to pass laws or issue regulations on seven
reforms, including coverage for people with preexisting medical
conditions, a ban on coverage waiting periods and limits for
out-of-pocket consumer costs.
The report coincides with the start of a new legislative
year for most states and comes 11 months before the reforms are
scheduled to take effect under Obama's Patient Protection and
Affordable Care Act, which is opposed by many states with
The law would expand health coverage to more than 30 million
people beginning on Jan. 1, 2014, partly by creating new
state-based online health insurance markets, or exchanges. These
would allow families to buy private coverage at subsidized
rates. Seventeen states won conditional approval to operate
their own exchanges, while more than 30 have opted for an
exchange run by the federal government.
The Commonwealth Fund, which focuses on ways to improve the
$2.8 trillion U.S. healthcare system, said states that fail to
act on key market reforms could end up lacking the authority to
enforce the changes in their home insurance markets and
ultimately cede control of those areas to the federal
Other reforms that many states have yet to address would
restrict insurers from charging more according to a
beneficiary's gender, age and health conditions; require
coverage of 10 essential health benefits; require plans to cover
at least 60 percent of costs; and stipulate that insurers accept
every individual and employer that applies for coverage.
"Because insurance regulation falls to the states, states
need to take action to make sure they can enforce the law and
ensure their residents can fully benefit from it," Commonwealth
Fund vice president Sara Collins said in a statement.
The report said that only Connecticut has passed legislation
addressing all seven of the new reforms. California has done so
for six of the seven. Nine states -- Arkansas, Maine, Maryland,
New York, Oregon, Rhode Island, Utah, Vermont and Washington --
have passed laws or issued regulations covering at least one.
The 11 states cited as having taken action on insurance
market reform include only nine of the 17 states that have been
approved by the U.S. Department of Health and Human Resources to
operate their own exchanges.