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Entries in DHE Consulting (1)

Monday
Oct262009

Health Insurance Lobby Worried About Direct Costs Of Reform

by Julianne LaJeunesse- University of New Mexico

Officials from various health care groups agreed on Monday that controlling costs and tackling health coverage for Americans with pre-existing medical conditions is going to require the masses. The issues were debated at a forum hosted by House Health Care Caucus Chairman U.S. Rep. Michael Burgess (R-Texas), who said that the the goal of the discussion was to figure out “how to affect [healthcare reform] without interfering with people’s freedoms and their rights in the process.”

President and CEO of America’s Health Insurance Plans Karen Ignagni started off by saying that “we as a community support reform.” Ignagni, whose organization represents over 1,300 companies that sell health insurance, added that her industry would like to guarantee coverage to all Americans, would like to end pre-existing condition limitations and exclusions, end gender differentiation, and no longer require health status ratings.

However, she argued that without both young and elderly Americans in the insurance pool, reform will make the system worse, citing unsuccessful examples of state mandated insurance as the basis for AHIP’s conclusion. She suggested that in addition to looking at mandated insurance, Congress should also address budget and fairness questions within reform.

“To what extent should people, who have no choice but to be in the pool, subsidize folks that decide to wait until they absolutely need coverage to get in?” asked Ignagni. “That’s a societal question, it’s a fairness question… and it’s a very important question… [and] the third issue is the budgetary imperative.”

Former Congressional Budget Office Director Doug Holtz-Eakin also raised fiscal questions about the Senate and House bills, saying neither will bend the health care cost curve.

“The entitlement that’s set up in the House program grows at 8 percent a year as far as the eye can see… faster than this economy will grow, faster than tax revenues will grow and thus is a fiscal risk in addition to not being a step forward in health care reform,” Holtz-Eakin said. “Oddly enough, the Senate bill, that was delivered by the Senate Finance Committee, also has an entitlement that grows at 8 percent per year…and thus fail[s] the fundamental test of lowering the growth rate of health care costs.”

Holtz-Eakin said that the health insurance industry could achieve a better business model if it adopted intervention practices such as prevention and early disease detection, which he said “would pay off over a life cycle.” He added that a business model that does so would reward quality.

On the issue of costs, Janet Trautwein, CEO of the National Association of Health Underwriters, was less open to removing pre-existing conditions without a more diverse pool of insured people.

“People with those pre-existing conditions use more health care…if we have only sick people in the pool, then we have defeated our purpose of affordability. And that is why we have a problem with the way in which pre-existing conditions may be removed from policies today.”