HEALTH NOTES

“Be Careful What You Wish For-

Particularly When It Involves Health Insurance”

PART III

Even state insurance regulators are opposed to this legislation, including those from Republican states such as Florida, where Kevin McCarty, Director of Florida’s Office of Insurance Regulations states, “I regret that I can not support your bill in its present form and ask that you reconsider the direction that it is being taken.” The National Association of Insurance Commissioners also opposes the bill in its present form, citing the bill’s pre-emption of state premium rating requirements and noting that “states are in the best position to determine what rating policies are best for their consumers both healthy/sick and we believe that in its current form S1955 will have a negative effect on many states.”

Nevada Insurance Commissioner, Alice Molasky-Arman, noted in Mr. Hiltzik’s article in the LA Times “the bill would only require coverage of procedures that are mandated in 45 states. That’s a higher bar. Among the current California mandates that wouldn’t qualify under the ENZI bill are mental health, diabetic equipment and supplies; contraceptives; well baby care, and mammograms, Pap smears, and prostate cancer tests.”

According to Mr. Hiltzik’s article, “the bill vastly expands the number of employee characteristics an insured can use in setting premiums. In California, that number is 3: age, family composition and geographic region. The range of prices the insurer can charge within each category furthermore is tightly constrained.

Under the Senate bill, insurers will also set rates based on factors such as gender and the nature of the employer’s business. The price ranges would be vastly expanded too. Plainly, this would constitute an open invitation to the scourge known as ‘cherry picking.’ Insurers would have the ability to price employers with a high-risk profile entirely out of the market - such as those employing chiefly women, or older persons, or engaged in riskier trades.”

My reason for writing this article has been to inform you, my reading public, about this legislation which will be hitting the news relatively soon; however, which has been stifled in the news, up to now. My concern is that this legislation which will affect all of us in this state, whether we be self-insured or insured through a large business. I feel that you must understand and become involved in this issue, or you will feel the repercussions if this legislation were to pass the full Senate. Many of us look to legislatures, both on a state and federal level, to assist with many of the dilemmas we find ourselves in today, relative to healthcare costs. Unfortunately, the legislature may not be the best venue in all instances to see that we receive assistance with this significant issue. To quote Ronald Reagan, “the most terrifying words in the English language are; I’m from the government and I’m here to help.’”

Keep your eyes peeled for this legislation in other news outlets, and make your voices heard regarding your concerns relative to this legislation. If you would like to receive more information regarding S1955, feel free to contact my office at 215-679-7800. I thank you for your time and consideration on this urgent issue.