When buying health insurance is MANDATORY, could ANYONE object to government rate regulation?

[ProgressiveEconomist]

government rate regulation? IMO the rate-regulation ideas in President Obama's health reform proposal are purs genius, will not draw any fire from Republicans Thursday, and will cut the legs from Republican calls for backdoor health insurance deregulation through "allowing purchases across state lines".

I watch "Inside Washington" regularly and have been stunned for months by arch-right-wingnut's Charles Krauthammer's repeated advocacy of health insurance rate regulation rather than the "public option". I was quite pleased to see that the President's proposal, posted on whitehouse.gov this morning, includes regulatory language (below) that not even Charles Krautheimer could assail (unless he goes back on what he's said many times in the past).

While the public option has been quite controversial, I have not heard ANYONE object to federal/state regulation of the rates corporations will charge for government-required health insurance. Except for Krautheimer, the far right seems to have been completely silent on the issue of rate regulation for mandatory insurance.

HAVE YOU heard any voices on the right object to rate regulation?

**** What'e your opinion? *****

IMO, the rate-review provisions in Obama's healthcare proposal, to be discussed on Feb 25th at the WH, are completely unassailable:

From http://www.whitehouse.gov/health-care-meeting/proposal/whatsnew/affordability

"Strengthen Oversight of Insurance Premium Increases.

Both the House and Senate bills include significant reforms to make insurance fair, accessible, and affordable to all people, regardless of pre-existing conditions. One essential policy is �rate review� meaning that health insurers must submit their proposed premium increases to the State authority or Secretary for review.

The President�s Proposal strengthens this policy by ensuring that, if a rate increase is unreasonable and unjustified, health insurers must lower premiums, provide rebates, or take other actions to make premiums affordable. A new Health Insurance Rate Authority will be created to provide needed oversight at the Federal level and help States determine how rate review will be enforced and monitor insurance market behavior.

[Oregone]

1. If buying insurance is mandatory and government regulates rates & service, can anyone object to just

socializing the entire damn industry? If the government is working overtime to make it work, why the fuck is a middle man needed to add bloat and suck up some profits off a system that government could run itself? The more strangelhold you put on insurers, and the bigger burden you put on the government to make sure they follow rules, the less reason you leave for them to even exist in the first place (other than to add profit to the cost of healthcare).

[ProgressiveEconomist]

4. IMO, now is exactly the wrong time politically to put single-payer on the table. I agree

with you that single payrer--likely n the form of resetting the eligibililty age for Medicare lower and lower overtime--would be superior to what'w on the table now. But exactly when Obama is going to make the Repubs EAT IT is not the time to snatch defeat from th ejaws of victory.

Single payer is a goal for the future, IMO.

[daleanime]

6. It will never be the right time to put single payer...

on the table. They tried like hell to keep it off the table in the first place. But guess what? It's on the table now and it's never going to come OFF the table until we have it. The only question is how much damage to the nations economy will we suffer through before it done.

[ProgressiveEconomist]

7. Single payer is "on the table" now? Who's going to undercut Democratic unity with

President Obama and raise it on Thursday? Franken? Weiner? Sanders?

[daleanime]

10. I think we talking about different tables...

no it doesn't seem to be on Obama's table, but how many voters agree with that? In spite of the best media spin money(and I mean lots of it) can buy over 60% of Americans continue to support single payer. Thats the table I'm talking about! Do you really think that what's on Obama's table will feed anyone except of insurance companies?

[Oregone]

9. Keep on keepin that powder dry

This reform is a direct repudiation of socialism. Im not sure that helps the future goal of single-payer one bit.

[kestrel91316]

2. The only way the RW will agree to mandatory insurance is if there is NO price regulation.

You DO realize that the ONLY thing they care about is corporate profits, don't you??

[ProgressiveEconomist]

5. Yes--I agree that Rs mainly care about the interests of the high-income and corporate

"contributors" that bankroll them. But they have to be able to bamboozle their ignorant "social issues" dupes into supporting thier positions. It is qute rare that they support corporate pillage without some cover story that will fool Fox viewers into believing it's NOT about the money.

IMO what's beautiful about health insurance rate regulation is that Rs cannot find a cover story for opposing it. Even Rush Limbaugh "dittoheads" can see that when corporations are allowed into thier pockets somebody has to make sure they're not just taking the money and running.

[tranche]

3. Yup. I think there's definitely something here.

[dflprincess]

8. Too little, too late

the rates are already unaffordable, how does regulating them now help?

[ProgressiveEconomist]

11. Minimum "loss ratio" regulation WOULD be retroactive, and essential, IMO

Another proposal that has met little opposition so far is that the "loss ratio" for health insurance companies be regulated and never fall below a certain percentage--85 percent was the figure I heard most often.

In the screwed-up world of corporate-provided healthcare, the medical "loss ratio" is what is actually spent on healthcare for policyholders, rather than on 8-figure executive salaries, bonuses, skyscrapers, high-end paintings and sculpture, shareholder dividends, etc.

When governments mandate that people MUST buy coverage, "loss-ratio" regulation would seem to be every bit as important as rate-increase regulation, don't you think?

I know loss-ratio regulation is in the House bill, but I'm not certain about the Senate bill or the proposal on the WH website.

[dflprincess]

12. Retroactive how far back?

The number of people unable to access care because they are uninsured or underinsured has been growing for years. They aren't going to go back far enough to make insurance affordable - not if you want a policy that actually lets you see a doctor when you need one.

[ProgressiveEconomist]

13. Sorry I confused you with the word "retroactive". I was imprecise. It would not be feasible

for any health insurance reform to be "retroactive" in TIME--nobody could expect a rebate of premium overcharges paid before the new law went into effect.

What I meant was that not just rate INCREASES would be regulated, but also rate LEVELS. There would be retroactivity in health insurance rate LEVELS:

For instance, some health insurance companies rake in 35 cents in profits and non-medical expenses from every dollar in premium income from policyholders. Regulation could not just prevent those companies from raising their rates further, but could also force them to CUT rates, so that profits and non-medical expenses would only make up 15 percent of premium income.

[dflprincess]

15. Again, too little, too late

those rates won't get cut far enough to make insurance affordable - unless you buy a policy with a deductible that's so high you still can't get care.

[Better Believe It]

14. Will the health insurance industry be able to increase rates without prior government approval?

The answer is YES.

So what kind of regulations are we talking about?

According to President Obama's proposal:

"If a rate increase is unreasonable and unjustified, health insurers must lower premiums, provide rebates, or take other actions to make premiums affordable."

Define unreasonable and unjustified.

This is about as general and vague as one can get.

And what will the panel do if they determine a rate hike is unreasonable? Well, they can do all sorts of things to bring down those premiums. They could even propose rebates .... or they might not. That's pretty much left up to the panel members to decide with no apparent clear guidelines on how to proceed with punitive actions. Of course, the insurance industry anti-trust exemption will remain intact so the insurance companies won't have to worry too much.





The President�s Proposal strengthens this policy by ensuring that, if a rate increase is unreasonable and unjustified, health insurers must lower premiums, provide rebates, or take other actions to make premiums affordable. A new Health Insurance Rate Authority will be created to provide needed oversight at the Federal level and help States determine how rate review will be enforced and monitor insurance market behavior.

[ProgressiveEconomist]

16. "Define unreasonable and unjustified"

That sounds like the kind of detail that may have to be worked out "in the regs", after health care reform has been signed into law. Secretary Sebelius would propose regulations and post them in the Federal Register for comment by a deadline. Then HHS would issue regulations that health insurance companies would have to follow.

One way to define "unreasonable and unjustified" would be that the "medical loss ratio" for an entire company fails to meet or exceed a minimum threshold--such as 85 percent.

A hardball rule would be that NO premium increase for anyone is "reasonable and justified" unless the whole-company medical loss ratio meets or exceeds 85 percent.

[Better Believe It]

17. It would be much easier to require prior federal approval for rate hikes.

And the insurance industry should of course be required to open all of their financial books to both government and public inspection.

[ProgressiveEconomist]

18. If insurance companies must pre-announce rate hikes, isn't this a distinction without

a difference?

Is the premium increase in your insurance bill ever a complete surprise to regulators?

Policyholders may not pay much attention to pre-announcement letters form insurance companies, but regulators will--if theyre on the ball.

Maybe most state insurance regalations already require pre-announcement of rate hikes.

To take care of states that don't, maybe the health insurance reform bill should include explicit 3-month advance notice of rate increases for regulators and policyholders nationwide.