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Chamber Analyzes PL 5,740/2023, Which Prohibits Health Plans from Denying Coverage to Seniors with Preexisting Conditions. Proposal Guarantees Enrollment Within Five Business Days and Fines for Noncompliance.
In February 2024, the Chamber of Deputies began to process the Bill No. 5,740/2023, already approved by the Federal Senate, which promises to change the rules for joining health plans in Brazil. The text prohibits operators from denying coverage to seniors and people with disabilities, even when there are preexisting conditions, and mandates that enrollment must be completed within five business days after the request.
The proposal was presented by Senator Flávio Arns (PSB-PR) and aims to combat age discrimination and the exclusion of people with chronic conditions attempting to enroll in private health plans.
What PL 5,740/2023 Says
According to the project, individual and family health plans will no longer be able to refuse enrollment for seniors under the argument of preexisting conditions, such as diabetes, hypertension, or heart diseases.
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The text further establishes that, once enrollment in the plan is requested, the operator will have up to five business days to finalize the contract, under penalty of administrative fine. Currently, there is no defined deadline in law, leaving many seniors waiting months for a response from companies.
According to the project’s author, “there are cases where elderly individuals go without medical coverage for weeks, just when they need care the most. What the project does is guarantee a minimum of dignity and agility.”
Why the Proposal is Necessary
The Elderly Statute (Law 10,741/2003) already prohibits abusive adjustments based on age and ensures equal access, but there are still legal gaps that allow refusal of enrollment by operators.
Currently, companies claim financial risk and high costs to deny entry for new beneficiaries over 60 years old, especially those with complex clinical histories. PL 5,740/2023 seeks to close this loophole, making any refusal based on age or health condition illegal.
The proposal also provides that the National Agency for Supplementary Health (ANS) monitors compliance with the new rules and publishes semiannual reports on denied enrollments.
Sector Reactions
Health plan operators, represented by the National Supplementary Health Federation (FenaSaúde), expressed concern about the financial impacts of the measure. According to the sector, the mandatory expansion of coverage for seniors could increase operating costs and, consequently, monthly fees.
Consumer protection and elderly advocacy groups, such as the Brazilian Institute for Consumer Defense (Idec) and the Mixed Parliamentary Front for Elderly Advocacy, celebrated the approval of the text in the Senate.
For attorney and consumer rights specialist Luiz Gustavo Rodrigues, consulted by Agência Câmara, “supplementary health cannot continue to choose who will live or die based on risk spreadsheets. The project guarantees the basic right of enrollment, which is currently denied to thousands of Brazilians over 60.”
Current Status of the Processing
PL 5,740/2023 was approved in the Federal Senate on January 26, 2024 and forwarded to the Chamber of Deputies in February of the same year.
In the Chamber, the proposal is under analysis in the Committee on the Defense of the Rights of the Elderly (CIDOSO) and will then proceed to the committees of Social Security and Family (CSSF) and Constitution and Justice (CCJ).
If approved without changes, the text will be forwarded for presidential sanction and could come into effect as early as 2025.
The Expected Impact
Experts estimate that the new rule could benefit over 3 million seniors who currently cannot enroll in a health plan. In addition to ensuring access, the project should reduce the litigation in the sector, which currently sees thousands of lawsuits regarding discrimination and denial of enrollment.
Brazil has over 50 million health plan beneficiaries, according to ANS, of which 7.5 million are over 60 years old. The trend of population aging makes the issue even more urgent.
PL 5,740/2023 represents a significant advance in the fight against age prejudice and medical exclusion.
If approved, the text could guarantee faster and more dignified healthcare for seniors and people with disabilities, as well as make the supplementary health market more transparent and accessible.
More than a bureaucratic change, the proposal reaffirms the principle that the right to health must prevail over economic interests.
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