President Jair Bolsonaro has until 26th to sanction the bill requiring health plans to pay for procedures or treatments not on the National Supplementary Health Agency (ANS) list. In the same week of the election, Bolsonaro will need to make a decision that will lead to controversy and outcry. If he vetoed or endorsed the measure, both situations would generate complaints from sections of society.
Faced with a stalemate, the president goes through a crisis and discusses with allies the decision that would cause the least amount of political damage on the eve of an election in which he fights voter disapproval. According to the interviewees, Bolsonaro will be more inclined to object to health plans’ obligation to cover procedures and treatments not on the ANS list when there is scientific evidence of efficacy.
Therefore, the trend will be for the president to prefer health plans over users. Thus, the political calculation is that electoral damage would be less if businessmen benefit. If he would prefer to approve the project the way Congress sent it, Bolsonaro will wave to the sick.
If passed the way the National Congress sent it to the Planalto Palace, the bill could raise questions in court around the country. According to the text approved by the Senate, the list of ANS procedures will serve as a reference for health plans only. With this, beneficiaries can request coverage for off-list treatments, as long as they have been identified by other agencies or there is scientific evidence.
The bill was first approved by the House of Representatives, in response to a Supreme Court of Justice (STJ) decision to establish that health plan operators are only obligated to pay 3,368 ANS-listed treatments. Without a list of actions, patients can try to get coverage that health plans previously denied.
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