State wants permanent insurance reform
June 6, 2012 | By Dina Overland - FierceHealthPayer
Insurers operating in California would have to provide some reform law
provisions--without an individual mandate--under two bills making their way
through the state legislature, regardless of the U.S. Supreme Court's ruling on
the law's constitutionality.
The main elements of the reform law, including requiring insurers cover
people with pre-existing conditions and limiting how insurers set premium rates
to age, geography and family size, would become permanent in California if S.B. 961 becomes law, reported Kaiser Health News/Capital Public Radio.
The legislation, which has an identical version in the state Assembly, also
prohibits insurers from conditioning individuals' coverage and costs on health
status, medical condition, claims experience or genetic information.
"I feel tremendous responsibility to ensure that California continues to lead
the nation, implementing federal reform, and that we serve as a model for the
rest of this country," Sen. Ed Hernandez (D-Calif.), who authored the bill, told
CPR. "While I remain optimistic that the U.S. Supreme Court will uphold
the Affordable Care Act, we still need the authority here in California to
enforce these protections," he added in a separate statement.
The California insurance industry, however, wants the bills to include an
individual mandate. "Disconnecting the requirement to join the insurance pool
from the duty to sell insurance at the same price, doesn't work," Patrick
Johnston, CEO of the California Association of Health Plans, told
CPR.
And Sen. Sam Blakeslee (R-Calif.) said that providing expensive care to
individuals with pre-existing conditions could raise costs for others or drive
some people out of the insurance pool, KPBS reported.
"If the U.S. Supreme Court strikes down the universal mandate as being
unconstitutional federally, then we would almost have to come back and institute
such a universal mandate here in California much like Massachusetts, or the
entirety of this would fail and potentially catastrophically," he said.