An insurance trade group today announced a “series of steps” to expand the number of Americans who have health insurance. “The proposals, approved by a board of the industry’s main trade group, would make it harder for insurers to cancel policies or deny coverage to people with pre-existing medical conditions. The steps would also limit the premiums that could be charged for such people.” The trade off? “The trade group also called on states to provide individual coverage for people who were likely to incur very high medical bills.”

The new proposals call for states to provide affordable coverage to anyone whose medical costs are expected to be at least twice the average. For other higher-risk patients who do not meet those criteria, the insurers would agree to cap the premiums at 150 percent of the market rate.

“‘We are taking responsibility for ensuring that no one falls through the cracks,’ said Karen Ignagni, the chief executive of the trade group, America’s Health Insurance Plans, which is based in Washington.” More realistically, the proposals are at least in part an attempt for insurers to have a stronger say in insurance discussions already underway in several states.

But the industry is also trying to have a greater say in any state changes that may be enacted. Many insurers chafe, for instance, over what they consider an overly regulated approach in Massachusetts, which has created an agency to oversee the market for individual insurers as part of a new law requiring everyone to buy coverage.

“This is advice to the states on how they can create functioning and viable marketplaces,” said George C. Halvorson, the chief executive of Kaiser Permanente, the California insurer, who chairs the trade group.

“Insurers Seek Bigger Reach in Coverage” [New York Times]
(Photo: Getty)

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