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Survey suggests many states lack regulatory oversight of individual health insurance market

(6/12, Gyllenhaal) reported on its website that "states do not have adequate laws to protect individual healthcare consumers -- people who are self-employed or ineligible for group health insurance coverage," according to a national survey by Families USA, a healthcare consumer group. Ron Pollack, executive director of Families USA, said, "Whether denying coverage for preexisting conditions, charging sky-high premiums, or digging into family history,...it's difficult for individuals to get health insurance they need." Many in the healthcare industry, however, say legislation "would increase costs and force many Americans to abandon much needed coverage."

The Indianapolis Star (6/12) added that the study "is the first 50-state survey of insurance commissioners that focuses on states' regulatory oversight of the individual health insurance market. That market is increasingly important as employer-sponsored health insurance declines and some elected officials promote its deregulated expansion." The survey found that "there are no limits on how much insurers can raise premiums based on an individual's health status" in 35 states and the District of Columbia." In addition, "n 20 states and the District of Columbia, insurers can set and raise premiums without meaningful oversight." And, "n 29 states and the District of Columbia, insurers are allowed to deny legitimate claims of policyholders who are up-to-date with their premium payments by digging back years into their medical history and alleging that they failed to disclose, or should have known about, a pre-existing condition."

Pollack stated that the individual health insurance market "is a market with many abuses and with far too few state-level consumer protections," according to the Kansas City Star (6/12, Karash). But, Bob Hanson, a spokesman for the Kansas Insurance Department, said, "You can create other problems you didn't foresee if you start guaranteeing coverage."

Modern Healthcare (6/13, Vesely) noted that America's Health Insurance Plans "is shopping [a] proposal to state lawmakers that would make changes to the individual market." AHIP spokesman Robert Zirkelbach, said, "We recognize that people are falling though the cracks, so we are taking steps to reform the market." The Detroit Free Press (6/12, Anstett) also covered the story.
 
"You can create other problems you didn't foresee if you start guaranteeing coverage."

At least there is some sanity.

What is with all this crap about regulating rates? Don't these people understand this is a competitive market place?

It's not like these carriers can raise rates at will with impunity.

Well, maybe if you are BX, but other than that . . .

These so-called market reformers will simply f**k up the market through mandates that raise the cost for everyone.
 
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