NU Online News Service, Jan. 12, 1:10 p.m.EST

Democratic members of the Texas House delegation yesterday askedtheir negotiators on health care reform legislation to require a"single, national health insurance exchange" in final legislation,a position opposed by all insurance agent trade groups.

All 11 Democratic members of the Texas House delegation signedthe letter to House negotiators, saying a national exchange isneeded to "protect Texans from second-rate care."

A national exchange is contained in the House version of healthcare reform legislation.

But because 60 votes are needed to get the bill through theSenate, Senate language giving states broad authority to regulatethe exchanges is considered more likely.

In their letter, the Democratic Texas House delegation said astate-based plan "reduces the market leverage of the exchange,increases complexity, and relies on laggard state leadership that,in Texas, would be unwilling or unable to administer the exchange,leaving millions of Texans no better off."

Further, the letter argued, "Larger exchanges and strongerregulators create better exchanges with more competition and moreprotection for consumers." The members urged adoption of theHouse's national exchange.

The proposal is not being supported by health insurance agents,however.

A coalition of all health insurance agent trade groups sent aletter today to members of Congress urging that states be allowedto regulate the exchanges. The agents' groups argued that only ifstate regulation is "preserved and strengthened" would meaningfulhealth reform take place.

The industry letter was drafted by officials of the Council ofInsurance Agents and Brokers; the Independent Insurance Agents andBrokers of America; the National Association of HealthUnderwriters; and the National Association of Insurance andFinancial Advisors.

The industry letter said it is "crucial" that Congress preservestate-based flexibility and utilize existing state-based regulatoryauthority through the nation's governors and insurancecommissioners.

"The federal regulatory functions of any exchanges should befocused on areas needed to facilitate the purchase of insurance byindividuals and small employers," the industry letter added.

But, the Texas Democratic House members took the oppositeview.

They contended that only through federal intervention will Texasresidents get top-quality health care.

"With one in four Texans living without insurance, we should notsettle for second-rate care. Instead we should ensure access to thelowest-cost, highest-quality insurance plans, which means we need anational health insurance exchange," said Rep. Lloyd Doggett,D-Texas, who is leading the Texas delegation's effort to ensurethat the House language is retained in a final bill.

"Historically in Texas, relying on state authority to providecare for its citizens has proved a treacherous path," the lettersaid.

"As it stands today, not one Texas child has received anybenefit from the Children's Health Insurance ProgramReauthorization Act approved by Congress early last year," theletter said.