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Insurers make pitch for health coverage mandate - Yahoo! News

WASHINGTON – The health insurance industry said Wednesday it will support a national health care overhaul that requires them to accept all customers, regardless of pre-existing medical conditions, but in return it wants lawmakers to mandate that everyone buy coverage.

Lawmakers have signaled their intent to craft health care legislation early next year, and the insurance industry's support would make passage easier. That legislation is expected to closely track the proposals of president-elect Barack Obama. However, Obama separated himself from his Democratic challengers by opposing an individual mandate for adults to buy health insurance.

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More lawmakers may agree to a mandate if it means the insurance industry will back those efforts. They'll remember it was the industry's opposition 15 years ago that helped scuttle former President Clinton's health plan.

The board of directors for America's Health Insurance Plans agreed to the trade-off Monday night. The board endorsed the proposal after a series of hearings in various states.
"We hope this will be a contribution to help members of Congress fashion their proposal," said Karen Ignagni, president and chief executive officer of the trade group.

"We're going to provide all the technical background that we have assembled, all the experience we've assembled at the state level, and we're going to work very hard with members of Congress on both sides of the aisle. We want to make sure that whatever reforms are advanced, no one falls through the cracks."

Obama's health plan calls for a health insurance exchange, a sort of government-run shopping center where customers could go to select from private plans or a plan administered by the federal government. Any insurer that wants to participate in that exchange must accept all customers regardless of pre-existing health conditions, such as diabetes or heart disease.

Insurers will want to participate in the exchange because government subsidies will make it easier for millions of people to buy coverage from them. But the insurers say that experience in the states shows the coverage guarantee often made it harder for people to find coverage. That's because insurers raised premiums to meet the expense of covering all applicants with chronic health conditions.

"They ended up making the problem much worse," Ignagni said of the state efforts. "The data is clear about the need to have everyone part of the system."
Analysts say Massachusetts is an example where the coverage guarantee has worked well, but it's also a state that requires everyone to buy health coverage or suffer a tax penalty.

Some key Democratic lawmakers have already expressed support for an individual mandate. The concept was a centerpiece of Sen. Hillary Rodham Clinton's health care plan. It was also part of the blueprint offered last week by Sen. Max Baucus, chairman of the Senate Finance Committee.
 
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Re: Is this good news???

Obama's health plan calls for a health insurance exchange, a sort of government-run shopping center where customers could go to select from private plans or a plan administered by the federal government. Any insurer that wants to participate in that exchange must accept all customers regardless of pre-existing health conditions, such as diabetes or heart disease.

Sounds like the current way medicaid/MA is run. Won't do anything for the agents, imo
 
Re: Is this good news???

I'm convinced there will be change of some kind.

There's just too much energy for it, and to look at it objectively - it's sorely needed.

Don't think anybody knows what the final form will be.
 
Re: Is this good news???

we already have risk pools......whats the point.....
 
Re: Is this good news?

how in the world could the government tell me I HAVE to buy health insurance? That is insane.

No it isn't.

If someone shows up at the Emergency Room door expecting to receive care, why shouldn't they have some provision to pay for it?

As it is now, the folks who do have insurance are subsidizing the ones that don't. That should change.
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we already have risk pools......whats the point.....

Not all states have risk pools.
 
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Re: Is this good news???

It is mandated right now for all in TX to buy car insurance, but not all do it.

All we have to do is look to NY on the health ins deal, they mandated that the companies take everyone, and major players just pulled out. Mass. came later: I wonder how it is working there? The "risk pool" is different in each state. I think major players start seeing they need to accept all risks, and they pull out. In all states. Once they start pulling out, we get the government stepping in. Similar to MA.
 
Re: Is this good news???

They tried to get this through in CA last year, but it was defeated largely owing to certain "single payor" advocates in the CA legislature.

The mandate is a critical component to make it work. Without the mandate, nothing can change. Adverse selection would continue, a large chunk of the current "uninsured" market either chooses not to buy it (although they are able health and financial-wise) or chooses to use "free" or low-cost community services instead.

The carriers are smart here. GI with mandate balances (and finally creates) the proper risk pool for non-employer-sponsored health insurance. Group works because of the participation requirements (mandate) which allow the carrier to spread risk across a pool. With no mandate on individual plans, there is no way for a carrier to determine how to pool and spread risk, so we end up with an underwriting system that filters out all but the healthiest applicants.

Given that something is going to change in the next few years, the choices are only two (the current system will not stand):

1 - mandated coverage with GI available (everyone must have coverage either through work or privately)

2 - single payor coverage provided by the government

The carriers are trying to head off number 2 by creating a workable system for number 1.
 
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