Primer on Post Claims Underwriting and Rescission Practices

Findings from Texas in the Individual Health Insurance Market

This case study examines the current state of post-claims underwriting and rescissions regulation in Texas. The authors report that consumers are vulnerable in today’s individual insurance market and that Texas state law does not clearly and consistently reflect the federal HIPAA standard, which could create loopholes in consumer protections. The authors also note that the Texas case offers important lessons for national health reform on five key topics:

  • federal and state regulatory standards;
  • consumer education and outreach;
  • complaint tracking and response;
  • market conduct reviews; and
  • role of federal regulators.

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