Senate committee hears split testimony on bill to bar insurers from owning health providers

A Senate commission held a public hearing on March 13, 2024, to examine Proyecto del Senado 1270, a bill that would prohibit health insurers and their affiliates from holding economic interests in providers and would declare health care and health insurance matters of high public interest.

Chair José Chaco Vargas Vidort opened the session by describing the bill’s aims and displaying organigrams from major insurers — including First Medical, Triple‑S, MMM, MCS, Menonita and Auxilio Mutual — arguing those structures create incentives that can channel patients into insurer‑owned clinics.

Roxana Rosario Serrano, executive director of the Administración de Seguros de Salud (ASES), read ASES’s written analysis. ASES noted that about 46 percent of Puerto Rico’s population gets coverage through the government plan and that the agency must meet federal network adequacy standards to certify access. Rosario Serrano said those rules and the practical shortage of specialists on the island have led ASES to grant limited exceptions permitting insurer‑affiliated facilities to participate in provider networks when necessary to maintain access. “Una aprobación de excepción para que el hospital pueda operar como parte del programa,” she said, describing the contractual and federal constraints that shape…