Comments made during the National Association of Insurance Commissioners meeting produced two sharply differing views among state regulators over the future benefit of health care reform to consumers.
Connecticut Commissioner Thomas R. Sullivan was highly critical of the potential benefits of the federal act, despite voting for the MLR form. He said while there was a promise from President Barack Obama that consumers can keep their health plan if they like it and that the program would save money, he believes this is far from the truth.
(President Obama was originally scheduled to address NAIC attendees on health reform but cancelled at the last minute, although he was in town for fund-raising events.)
Mr. Sullivan said that based on figures from the Government Accountability Office, instead of saving money, the federal reform program would produce unfunded liabilities. Consumers will lose their ability to choose their health care program as the competitiveness of the insurance market erodes. He said he fears the "intrusive arm of government," and that the law would not provide relief from escalating health care costs, which he argued cannot be managed until the inflation connected with medical care itself is addressed.
Illinois Insurance Director Michael T. McRaith, on the other hand, said his state does not have a competitive health insurance market and he welcomed the federal act.
He told a story illustrating the unfair practices of health insurers, concerning a woman who was denied benefits under her plan for help with dealing with the death of a loved one because she sought grief counseling at her church. "In Illinois, even grief is a preexisting condition," he said.
He was critical of health care insurers' practice of denying benefits to consumers in his state and the inability of consumers to combat the situation.
In making their insurance purchasing choices, consumers have the option of choosing the car and home they want to insure, and who to insure it with, "but you cannot choose to have cancer," he remarked.
NAIC President Jane L. Cline, addressing her fellow regulators, said the NAIC's work has been dominated by state implementation of federal health care mandates. West Virginia's insurance commissioner added that NAIC working groups have held more than 280 meetings on the subject since passage of the Patient Protection and Affordable Care Act and received more than 400 documents from "interested parties."
The NAIC's conference call bill alone stands at $80,000, she noted to illustrate how much effort the NAIC is putting into implementation.
"Our challenge is enforcement," she said, adding that there needs to be an open and transparent process as "we all have a hand in the future of health care."
A presentation by Kansas Insurance Commissioner Sandy Praeger noted that regulators' health care responsibilities include speed-to-market form and rate filings, with the major concern being that premiums are adequate to avoid insolvency without being excessive. Policy language will also need to be uniform and understandable for consumers, she said.
The states have until 2014 to set up health insurance exchanges, and Commissioner Praeger said the states have an obligation under the law to set up such exchanges before the federal government steps in.
"When you stop and think about it, we have just scratched the surface on implementation issues," she observed. "The work is ongoing.
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