Health Mandate Softens

By ALLISON BELL

Published 9/24/2009

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Members of the Senate Finance Committee may have watered down the individual health insurance purchase mandate in their version of the health reform bill.

The committe is continuing to revise, or "mark up," a modified version of the America's Healthy Future Act bill, a health reform proposal developed under the direction of Senate Finance Committee Chairman Max Baucus, D-Mont.

One principle backed by both President Obama and America's Health Insurance Plans, Washington, is that the health reform bill should include a requirement that health plans accept applicants with preexisting conditions, without charging them higher prices because of their health status, along with a requirement that individuals have health coverage, to protect health plans against the risk of antiselection.

Sen. Charles Grassley, R-Iowa, today proposed an amendment to the AHF

A bill that would let states opt out of the individual health insurance ownership mandate and switch to other arrangements approved by state insurance commissioners as actuarially sound.

Alternatives to a health insurance plans could include reinsurance programs or "other policies that we haven't thought of yet," Grassley, the highest ranking Republican on the Senate Finance Committee, said. "It's a mistake to think that Washington has all the answers."

Grassley said he proposed the amendment because he decided during the Senate's August recess that imposing an individual health coverage mandate would create new problems.

"There is of course a principle of personal responsibility," Grassley said. "We all one way or another pay for the health care for the uninsured. A mandate helps stabilize premiums, mostly by requiring younger people to buy insurance."

Moreover, "it's easy to see why the health insurers want the mandate," he said. "It's going to make them a heckuva lot of money."

But, under the AHFA bill, the government could impose up to $1,900 in new taxes per year on a family that goes without coverage, and the idea of requiring an individual or family to own coverage that meets lengthy federal benefits requirements is ano

ther cause for concern, Grassley said. He also questioned the idea of adopting a program that would create subsidies for families earning as much as $88,000 per year at a time when the United States has a giant budget deficit.

Sen. Ron Wyden, D-Ore., brought debate of the proposed Grassley flexbility amendment to a halt by noting that Baucus already has approved a state flexibility amendment that he has offered. That amendment already would let states go with alternatives to the health insurance mandate requirement, Wyden said.

"I wanted to give [states like Oregon] the maximum amount of flexibility," Wyden said.

Grassley agreed to hold back on further discussion of his flexibility amendment while he determines whether the Wyden amendment would really do the same thing.

Earlier, members of the committee agreed unanimously to approve an amendment, proposed by Sen. Debbie Stabenow, D-Mich., that would let dental insurers team with medical insurers to offer coverage packages through the proposed health i

nsurance exchanges for individuals and small businesses. Earlier, some had suggested that the Baucus AHFA bill might let dental insurers participate in the exchanges only by offering stand-alone plans.

Stabenow said she kept vision coverage providers out of the bill for technical reasons.

Grassley noted that Iowa dental providers have talked to him to ask him where they would stand in the health exchange system.

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- 9/25/2009 2:36:12 PM
- Jeff Fine
- Senate Health Bill
- What's the current status of the section that penalizes doctors for Medicare patients who, for at least 5 years (from 2015 to 2020) authorize total treatments that wind up in the top 10% of national annual Medicare costs per patient? If this provision stays in the proposal, it means that all doctors treating older people will be driven to try to order the least expensive tests and treatments for fear they will be caught in that top 10%. Where is the consideration of quality, efficiency or waste? Notwithstanding the current section on page 80, doesn't the pressure on doctors realistically continue? Isn't this penalty a moving target because there will always be a top 10%? The government is taking the heat off its back by passing the buck - in reality, this is a penalty that would be assessed against the Medicare population. Any response?
- 9/25/2009 2:39:03 PM
- gposner
- Medicare Advantage Plans
- Just be sure these "plans" are either eliminated or drastically cut back. Absolutely wasteful pork...Seniors are fine with medicare & a supplement or medicare and public aid.
- 9/25/2009 3:58:32 PM
- Harold Patman
- Health Insurance Mandates
- After a long career in the insurance business, it escapes me how you can cover all pre-existing coverages and not have a mandate. The only way this can work is to assure that those in good health participate in order to offset the antiselection of those with health conditions. The more I hear out of Washington, the more I am sure that they know little about what they are doing - and this is on both sides of the aisle.
- 9/25/2009 4:09:16 PM
- Jay A. Huminsky, RHU, REBC
- Exchange "Package"
- Adding dental coverage to a government run Exchange is inconsistent with the stated goal of lower affordable cost. If the uninsured doesn't currently have enough money to buy health insurance what is the purpose of providing a higher cost alternative other than an addition revenue stream for the government? Few dental insurance carriers in this country, if ever, have lost money. The probability of a catastrophic loss in the mandibular area for covered dental benefits is "Zero". If we are reforming the system, lets stick to basic risk management and economic principles, shall we?
- 9/25/2009 8:04:01 PM
- Richard S.
- What About Us?
- Has anyone read that this bill would include allowing agents to distribute the plan? I read that one of the two house versions did include using health agents. Otherwise, how are people actually going to enroll in this? By a toll-free number similar to enrolling in Medicare? Thanks everyone.
- 9/26/2009 11:43:52 AM
- AJExpress
- Most Honest Statement Yet...
- Grassley, the highest ranking Republican on the Senate Finance Committee, said. "It's a mistake to think that Washington has all the answers." (Coied directly from the article.)
- 9/28/2009 6:16:34 PM
- Larry Matson
- Tort reform
- In order for all of this to work, tort reform must be included inorder to reduce cost. The high cost of professional liability insurance/malpractice insurance has to be considered in this over all reform process.