Insurance companies are regulated differently. Large insurance companies are self-funded, so they are regulated by federal laws. Individual or small group policies are regulated by the states; it is the states that will set up exchanges where uninsured Americans will be able to purchase health care coverage starting in 2014, under the Affordable Care Act (ACA). When Congress discusses passing patients’ rights legislation, it tends to mean federally regulated plans that are self-funded through large corporations.
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