California is the only state with two agencies keeping tabs on the health
insurance industry.
The Department of Insurance regulates traditional indemnity health policies and some preferred provider plans. The Department of Managed Health Care, created in 2000 to oversee the Knox-Keene Health Care Service Plan Act of 1975, regulates health maintenance organizations and some PPOs.
Four years ago, as California prepared for changes the Affordable Care Act would bring, policymakers and state health officials briefly considered the possibility that the timing might be right to align the oversight of health insurance under one roof.
The idea didn’t go anywhere then but it resurfaced this summer with the publication of a report from the Health Insurance Alignment Project suggesting the time might be right now. The report by the Kelch Policy Group was commissioned by the California HealthCare Foundation, which publishes California Healthline.
The report concludes:
” … an unmistakable final finding of the Alignment Project is that the ACA presents policymakers with an unprecedented opportunity, and potentially some less disruptive options than in past years, to empower and hold accountable a single regulator with the clear mandate to put consumer protection at the center of health insurance regulation in California.”
We asked legislators, regulators, consumer advocates, health care experts and stakeholders:
Should California align health insurance oversight under one agency? If so, how and when should it happen?
We received responses from: