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Senator pitches annual Medigap open enrollment; insurers warn higher premiums and market disruption
Summary
Senate Bill 1181 would create an annual open-enrollment period for Medicare supplemental (Medigap) policies and bar insurers from denying or rate‑adjusting based on preexisting conditions; senior advocates supported the change and insurers and brokers warned it would raise premiums and destabilize the market.
Senate Bill 1181, which would create an annual guaranteed-issue open enrollment window for Medicare supplemental insurance (Medigap) and prohibit Medigap carriers from denying coverage or raising premiums based on health status, drew extended testimony March 27 before the Senate Committee on Health Care.
Senator Winswe Campos, the chief sponsor, told the committee the bill is intended to give older Oregonians more choice and protect people who develop serious conditions after age 65. "This bill helps us take another step toward ensuring that all Oregonians have access to quality health care... 86 percent of people aged 55 to 64 have a preexisting condition," Campos said, arguing an annual enrollment period would let seniors respond to network terminations or changes in coverage.
Patient and beneficiary groups supported the change. Adam Zarin of the Leukemia & Lymphoma Society said patients with conditions such as cancer can be effectively barred from Medigap plans if they miss the initial enrollment window; he emphasized out-of-pocket exposure for cancer patients without supplemental coverage. Andrea Meyer of AARP Oregon said the current system “binds” beneficiaries to choices made at age 65, and an annual option would restore flexibility.
Insurers, trade groups and brokers warned the committee the bill would raise premiums and shrink enrollment in Medigap. Elise Brown of America’s Health Insurance Plans (AHIP) and Mary Ann Cooper of Regence/Blue Cross Blue Shield of Oregon cautioned that a broader open enrollment and limits on age- or geography-based rating would attract enrollees with higher expected costs and push premiums higher for everyone. Brown cited an example from California in which regulators estimated a 33% increase in average Medigap premiums after a similar change. Tom Holt, a broker with the National Association of Benefits and Insurance Professionals (Oregon chapter), emphasized that geographic rating exists because costs vary across regions and warned the bill would shift costs across places such as Bend and Salem.
Proponents countered that states with continuous or annual enrollment still maintain robust Medigap markets and that the financial protection offered by Medigap can be critical: one witness said a multiple myeloma patient without supplemental coverage could face roughly $31,000 in annual out-of-pocket costs. Supporters urged the committee to weigh the balance between access and price.
The committee did not take final action on SB 1181 on March 27; members asked for further information and discussion of actuarial estimates and consumer impacts before any vote.
Ending: The hearing laid out a trade-off central to the bill: expand access for people who develop or discover significant health needs after age 65 versus the risk of higher premiums for the entire Medigap pool. The committee closed the public hearing and requested more actuarial and policy analysis.
