WASHINGTON —The health insurance industry said Tuesday that it was willing to end the practice of charging higher premiums to sick people if Congress adopted a comprehensive plan that provided coverage to all Americans.
The industry’s flexible position on the issue came as a surprise to lawmakers, and could make it easier to reach an agreement in Congress because it narrows the issues on which insurers are ready to fight the Democrats who control Congress and the White House.
Insurers said they were still staunchly opposed to creation of a new government-run health insurance plan, which, under many Democratic proposals, would compete directly with private insurers.
In effect, insurers said they were willing to discard an element of their longstanding business model, under which insurance policies are priced, in part, on the basis of a person’s medical condition or history.
In the past, insurers have warned that if they could not consider a person’s health in setting premiums, the rates charged to young, healthy people would soar, making coverage unaffordable.
But Karen M. Ignagni, president of America’s Health Insurance Plans, a major trade group, told lawmakers on Tuesday that insurers were exploring ideas to prevent such increases by spreading the risks and costs across a larger population of both healthy and unhealthy people.
Insurers said that they could accept more aggressive regulation of not just their premiums but also their benefits, underwriting practices and other activities. Such strict regulation, they said, would make a new public program unnecessary.
The insurers set forth their position at a Senate hearing on Tuesday and in letters to the Democratic chairmen and senior Republican members of the two Senate committees primarily responsible for health care legislation.
The letters were signed by Ms. Ignagni and Scott P. Serota, president of the Blue Cross and Blue Shield Association.
Senator Jeff Bingaman, Democrat of New Mexico, who presided over the hearing, welcomed the insurers’ position.
“It was a significant step for them to take,” Mr. Bingaman said in an interview. “That’s certainly not been their position in previous years. I hope it moves us closer to something that we could label a consensus.”
Senator Max Baucus, the Montana Democrat who is chairman of the Finance Committee, also welcomed the insurers’ stance. “It indicates that we may be able to have health care reform this year because the major players are stepping up and saying they are willing to play,” Mr. Baucus said.
Sandy Praeger, the Kansas insurance commissioner, who testified Tuesday on behalf the National Association of Insurance Commissioners, said the companies were taking “a very good step in the right direction.”
“As we move toward getting everybody covered,” Ms. Praeger said, “we have to get rid of health status as a rating factor.”
Regulation of premiums in the individual insurance market varies among states. Premiums for a person with a history of serious illness are often 50 percent higher than premiums for younger, healthier people — if the sick people can get coverage at all, she said.
In November, two weeks after the presidential election, the industry said it could support legislation requiring insurers to accept all applicants, regardless of illness or disability. In return, the industry said, Congress should require all Americans to have coverage.
At that time, the industry pointedly refused to say whether it would accept stricter regulation of its rates, to limit the variation in premiums.
In their letter to Congress, Ms. Ignagni and Mr. Serota said that if Congress enacted an enforceable requirement for everyone to carry health insurance, “we could guarantee issue of coverage with no pre-existing condition exclusions and phase out the practice of varying premiums based on health status in the individual market.”
However, the two executives said that insurers wanted to retain the right to charge different premiums based on the age, place of residence and family size of subscribers.