Health Care Reform Bill Draws Measured State Regulators' Response

In that case, she said, it is the role of insurance commissioners to provide impartial information as it is requested so that the legislators can make decisions.

Kansas Insurance Commissioner Sandy Praeger, who is chair of the NAIC Health Insurance and Managed Care Committee agreed, stating that regulators are responsible for making sure that when legislatures do make decisions, those decisions are based on accurate information and experiences from insurance departments.

Speaking to the threats of lawsuits that have cropped up from some states since the passage of the bill in the House of Representatives, Commissioner Praeger said such actions will not delay insurance commissioners from beginning work on implementing reforms where they are required to do so.

Jane Cline, NAIC president and West Virginia Insurance Commissioner said, "We're going to be proactive in making sure we move forward in areas identified for us to move forward."

But Commissioner Holland said there are still issues that will require action from state legislatures, and the speed of implementation could differ among the states depending on how the legislatures react.

Speaking to the bill itself, Commissioner Praeger said the biggest impact will be protections afforded to consumers in the individual marketplace. As an example, she said consumers who want to leave their job to start their own business will be able to do so without worrying whether a pre-existing condition will complicate obtaining medical coverage.

As far as costs, Commissioner Praeger said there should not be any big changes in employer-based health coverages. Any impact in that arena, she said, could be positive if more people are insured.

But with the rating bands in the individual market established by the reforms, Commissioner Praeger said healthy young people may have to pay more at first, as the ban stipulates they can only be charged a third of what an older person is charged.

Commissioner Holland noted that inadequate penalties for not buying coverage may not provide the proper motivation to get "young invincibles" into the marketplace.

Commissioner Holland also said an area of criticism has been the lack of focus on reducing costs. She said many of the reforms will actually increase premium costs. While out of pocket costs may be reduced by the reforms, insurance costs are likely to be "substantially more," and she said there is concern among many that the cost of the bill will loom to a larger extent than predicted.