Health Insurer Groups Back Parts of Baucus Health Care Reform Plan

In separate announcements on Wednesday, America's Health Insurance Plans and the Blue Cross and Blue Shield Association said that they would support guaranteed health coverage for people with pre-existing health conditions, as long as lawmakers also approve an enforceable requirement that all U.S. residents obtain coverage, the New York Times reports (Pear, New York Times, 11/20).

Both of the industry's proposals are included in a health care overhaul plan released last week by Senate Finance Committee Chair Max Baucus (D-Mont.) (CongressDaily, 11/19).

President-elect Barack Obama's proposal would require insurers to cover people with pre-existing conditions but initially would apply the coverage requirement only to children.

On Wednesday, Congressional lawmakers said that they want to pass health care legislation next year that is in line with Obama's proposal.

According to the Times, "The new position taken by the insurance industry -- the industry that helped sink President Bill Clinton's plan for universal health coverage in 1994 -- could ease the way for passage of such legislation."

The insurers said that unless a coverage requirement is adopted, people will wait until they become sick to purchase insurance.

Industry Comments

Alissa Fox, a BCBS vice president, said, "Insurance works best when everyone is in the pool. You need healthy people in the insurance pool to help pay for sicker individuals who are much more motivated to buy coverage."

Donald Hamm, president of Assurant Health and a member of AHIP's board, said, "In the individual market, people can choose whether or not to apply for coverage," adding, "If they know they can obtain coverage at any time, many will wait until they get sick to apply for it. That increases the price for everyone."

The new policy statements do not offer recommendations for how to enforce a coverage requirement or how to regulate insurance prices or premiums.

Hamm said that the group might offer recommendations for creating "a fair and appropriate rating structure" (New York Times, 11/20).

The insurers also said that premiums should be kept stable through a "broadly funded reimbursement mechanism that spreads cost for the highest-risk individuals" (Bloomberg/Boston Globe, 11/20).

Karen Ignagni, president and CEO of AHIP, said, "We hope this will be a contribution to help members of Congress fashion their proposal," adding, "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" (Freking, AP/Philadelphia Inquirer, 11/20).

Advocates, Industry Offer Recommendations

Health care advocates and industry leaders have begun to offer recommendations for health care reform legislation that they expect President-elect Barack Obama and Congress to address next year, the Wall Street Journal reports.

According to the Journal, in a "stark contrast" to health care reform efforts in the 1990s, a "wide variety of interests groups are rooting for it to succeed rather than plotting to kill it" (Meckler, Wall Street Journal, 11/20).

Health Care for American NOW! on Tuesday launched a television advertisement that asked Obama to meet his campaign promises on health care despite the current economic downturn (Rhee, "Political Intelligence," Boston Globe, 11/18).

In addition, some large pharmaceutical companies have began "crafting plans to expand health insurance coverage and cut the escalating costs of care," Reuters reports (Richwine/Pierson, Reuters, 11/19).