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

Democratic members of the Texas House delegation yesterday asked their 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 signed the letter to House negotiators, saying a national exchange is needed to "protect Texans from second-rate care."

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

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

In their letter, the Democratic Texas House delegation said a state-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 stronger regulators create better exchanges with more competition and more protection for consumers." The members urged adoption of the House's national exchange.

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

A coalition of all health insurance agent trade groups sent a letter today to members of Congress urging that states be allowed to regulate the exchanges. The agents' groups argued that only if state regulation is "preserved and strengthened" would meaningful health reform take place.

The industry letter was drafted by officials of the Council of Insurance Agents and Brokers; the Independent Insurance Agents and Brokers of America; the National Association of Health Underwriters; and the National Association of Insurance and Financial Advisors.

The industry letter said it is "crucial" that Congress preserve state-based flexibility and utilize existing state-based regulatory authority through the nation's governors and insurance commissioners.

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

But, the Texas Democratic House members took the opposite view.

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

"With one in four Texans living without insurance, we should not settle for second-rate care. Instead we should ensure access to the lowest-cost, highest-quality insurance plans, which means we need a national health insurance exchange," said Rep. Lloyd Doggett, D-Texas, who is leading the Texas delegation's effort to ensure that the House language is retained in a final bill.

"Historically in Texas, relying on state authority to provide care for its citizens has proved a treacherous path," the letter said.

"As it stands today, not one Texas child has received any benefit from the Children's Health Insurance Program Reauthorization Act approved by Congress early last year," the letter said.

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