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Health Industry Proposes Coverage for All, Along With Individual Mandate
[November 19, 2008]

Health Industry Proposes Coverage for All, Along With Individual Mandate


(BestWire Services Via Acquire Media NewsEdge) The U.S. health insurance industry has proposed guaranteeing coverage to people with pre-existing medical conditions coupled with an enforceable mandate that everyone buy coverage.

Under its latest proposal, America's Health Insurance Plans said health plans participating in the individual health insurance market would be required to offer coverage to all applicants, known as "guarantee-issue," as part of a universal plan in which all individuals were required to maintain health insurance.



"AHIP?s board of directors is responding to the concerns of the American people by offering a workable solution to ensure that no one is left out of the health care system because of their health, age, income or employment status,? said Karen Ignagni, the group's president and chief executive officer, in a statement.

Efforts at broad-based U.S. health reform are gaining momentum.


Recently, Senate Finance Committee Chairman Max Baucus reached out to President-elect Barack Obama with a detailed plan to reform the health care system, including an individual mandate to buy coverage, something Obama opposed on the campaign trail. The plan arises out of the Prepare for Launch health care summit Baucus, D-Mont., and the Finance Committee's Ranking Republican, Charles Grassley, hosted earlier this year, with the chairman announcing plans to move legislation early in the 111th Congress (BestWire, Nov. 18, 2008).

An individual mandate is in place in Massachusetts. During the Democratic primaries, Obama sparred with rival Sen. Hillary Clinton, D-N.Y., over the mandate, which Clinton supports, arguing that it would lay an unfair financial burden on those who have trouble affording coverage. But Baucus argued the mandate was an essential part of comprehensive reform, as the cost of care for the uninsured today is "largely borne by those with insurance" ( Bestwire, Nov. 18, 2008).

Aetna Inc. (NYSE: AET) is a U.S. health insurer that supports an individual insurance mandate and praised the landmark Massachusetts law when it was enacted back in April 2006 (BestWire, April 17, 2006).

AHIP also is proposing refundable tax credits for moderate-income individuals and working families; tax equity whether coverage is obtained through an employer or the individual market. The group also supports premium stability for people with existing coverage through a broadly funded reimbursement mechanism that spreads costs for the highest-risk individuals.

Baucus' plan also includes features similar to Obama's own health care reform agenda, including a nationwide "health insurance exchange" through which individuals could purchase coverage. The national exchange would be open to those who do not receive or are unsatisfied with coverage provided by their employer or the government. Private insurers would participate in the exchange and would be prohibited from discriminating in either rates or underwriting on the basis of pre-existing conditions (BestWire, Nov. 18, 2008).

AHIP also reiterated its support for making eligible for the Medicaid program every poor, uninsured American and strengthening the Children?s Health Insurance Program. "Universal coverage is within reach and can be achieved by building on the current system," Ignagni said.

Clinton, considered a candidate to become Secretary of State in the Obama administration, was recently offered an alternative: to be a senior member of a Senate team on health reform, according to published reports. Sen. Edward M. Kennedy, D-Mass., who reportedly also announced plans to write broad health reform legislation next year, asked Clinton to head a working group focused on insurance coverage, according to reports.

(By Fran Matso Lysiak, senior associate editor, BestWeek: [email protected])

Copyright ? 2008 A.M. Best Company, Inc.

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