NU Online News Service, Dec. 23, 12:05 p.m. EST

WASHINGTON–The insurance industry continues to voice concerns that healthcare legislation likely to be enacted in the first quarter of 2010 will drive up healthcare costs significantly in the private market.

These concerns were being voiced as the Senate prepared to vote Thursday morning on its version of the legislation, the Patient Protection and Affordable Care Act of 2009.

The last procedural vote on Wednesday cleared the way for a final Senate vote on the bill at 8 a.m. Thursday. The bill comes up for final passage at an unusually early hour in order to give senators time to get home for Christmas, congressional staffers said.

"The finish line is in sight," Sen. Max Baucus, D-Mont., said at a news conference late Tuesday, adding, "We're not the first to attempt such reforms, but we will be the first to succeed."

However, insurance industry lobbyists have concerns.

In a letter to members of the Council of Insurance Agents and Brokers, the public option in the Senate bill has been replaced by a program requiring the federal Office of Personnel Management to oversee private individual and small-group plans that would be offered in state exchanges. The CIAB said it is still studying the proposal.

The Independent Insurance Agents and Brokers of America noted its concern with the coming reconciliation talks. The Senate's version will have to be reconciled with the House version passed earlier.

"Though the IIABA is opposed to the Senate version and will be working on further improvements to it in 2010, we will also focus our efforts lobbying against the more egregious and radical provisions found in the House bill so that they don't make it into the final package," said IIABA Charles Symington senior vice president of government affairs .

And the Senate bill specifically ensures the role of licensed health insurance agents in state exchanges, according to Janet Trautwein, chief executive officer of the National Association of Health Underwriters.

However, Ms. Trautwein added, "we would like to see these provisions expanded and clarified to ensure that all policies provided through the exchanges be available for purchase through an agent or broker."

According to CIAB officials, clarification of agent access will be a primary concern during reconciliation talks.

In general, Ms. Trautwein said, the Senate bill contains many provisions to drive up private health insurance costs significantly for millions of Americans and disrupt the quality of coverage.

Ms. Trautwein said the minimum loss ratio requirements added to the legislation last week "will significantly and negatively impact coverage choice and affordability."

She said NAHU's members "agree with the goal of providing consumers with more value for health care dollars spent, the 80-85 percent minimum loss ratios required for the individual and group markets in this bill far exceed any similar state-level requirements."

The bill also does not take into account the need to address underlying cost drivers in health care, she said and has an unworkable individual mandate.

CIAB said one new wrinkle in the Senate bill is new voucher provision that permits employees to get a voucher in lieu of coverage through a group plan, but only if certain conditions are met. These include an employee's premium contribution burden exceeding 8 percent of the employee's income and the employee must not make more than 400 percent of the federal poverty wage.

Senate passage expected Thursday would clear the way for a House-Senate conference early next year to reconcile the vastly different versions of the legislation.

But officials of Washington Analysis, which advises institutional investors, said that given the difficulty Democrats have had in gaining the 60 votes needed to pass the bill in the Senate, it is likely that the final product will most resemble the bill passed by the Senate.

The final Senate bill does not contain a public option, which is part of the House bill, and one of the industry's primary concerns.

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Senate Primes For Health Care Vote, But Industry Concerned

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