AHIP, BCBS Say They Support Guaranteed Coverage For People With Pre-Existing Health Conditions, As Long As All Individuals Required To Obtain Cover

Main Category: Health Insurance / Medical Insurance
Article Date: 21 Nov 2008 - 5:00 PDT

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America's Health Insurance Plans and the Blue Cross Blue Shield Association in separate announcements on Wednesday said that they would support guaranteed health coverage for people with pre-existing health conditions, as long as lawmakers also approve an enforceable requirement that all U.S. residents obtain coverage, the New York Times reports.

Some congressional lawmakers on Wednesday said that they want to pass health care legislation next year that is in line with the health care proposal of President-elect Barack Obama. According to the Times, "The new position taken by the insurance industry -- the industry that helped sink President Bill Clinton's plan for universal health coverage in 1994 -- could ease the way for passage of such legislation" (Pear, New York Times, 11/20). Both of the industry's proposals are included in a health care overhaul plan released last week by Senate Finance Committee Chair Max Baucus (D-Mont.) (CongressDaily, 11/19). Obama's proposal would require insurers to cover people with pre-existing conditions but initially would apply the coverage requirement only to children.

The insurers said that unless a coverage requirement is adopted, people will wait until they become sick to purchase insurance. Alissa Fox, a BCBS vice president, said, "Insurance works best when everyone is in the pool. You need healthy people in the insurance pool to help pay for sicker individuals who are much more motivated to buy coverage." Donald Hamm, president of Assurant Health and a member of AHIP's board, said, "In the individual market, people can choose whether or not to apply for coverage," adding, "If they know they can obtain coverage at any time, many will wait until they get sick to apply for it. That increases the price for everyone."

The new policy statements do not offer recommendations for how to enforce a coverage requirement or how to regulate insurance prices or premiums. Hamm said that the group might offer recommendations for creating "a fair and appropriate rating structure" (New York Times, 11/20). The insurers also said that premiums should be kept stable through a "broadly funded reimbursement mechanism that spreads cost for the highest-risk individuals" (Bloomberg/Boston Globe, 11/20). Karen Ignagni, president and CEO of AHIP, said, "We hope this will be a contribution to help members of Congress fashion their proposal," adding, "We're going to provide all the technical background that we have assembled, all the experience we've assembled at the state level, and we're going to work very hard with members of Congress" (Freking, AP/Philadelphia Inquirer, 11/20).

Advocates, Industry Offer Recommendations
Health care advocates and industry leaders have begun to offer recommendations for health care reform legislation that they expect President-elect Barack Obama and Congress to address next year, the Wall Street Journal reports. According to the Journal, in a "stark contrast" to health care reform efforts in the 1990s, a "wide variety of interests groups are rooting for it to succeed rather than plotting to kill it" (Meckler, Wall Street Journal, 11/20).

Health Care for American NOW! on Tuesday launched a television advertisement that asked Obama to meet his campaign promises on health care despite the current economic downturn (Rhee, "Political Intelligence," Boston Globe, 11/18).

In addition, some large pharmaceutical companies have begun "crafting plans to expand health insurance coverage and cut the escalating costs of care," Reuters reports (Richwine/Pierson, Reuters, 11/19). On Wednesday, leaders of labor unions during a seminar sponsored by the Connecticut Health Advancement and Research Trust discussed the need for health care reform (Holahan, Harford Courant, 11/20).

CNN's "Lou Dobbs Tonight" on Wednesday examined the differences between the health care proposals announced by Obama and lawmakers and the effect that those plans might have for U.S. residents (Pilgrim, "Lou Dobbs Tonight," CNN, 11/19).

Editorials

• Christian Science Monitor: "Nearly all the great issues facing Obama involve science or technology as part of the solution," a Monitor editorial states. According to the editorial, "Obama has pledged to 'restore integrity' to U.S. science policy by making decisions informed by the best available evidence," as well as increase funding for scientific research. In addition, Obama will "need to deal with the promise and perils of biotechnology and nanotechnology," among other issues, the editorial states. The editorial concludes that his science adviser should "sift through the blizzard of data and ensure that the president has before him viable choices based on sound science" (Christian Science Monitor, 11/20).
  
  
• Wall Street Journal: "Now liberals think the political moment has finally arrived to achieve ... government-run health care," based on the health care reform proposal released by Senate Finance Committee Chair Max Baucus (D-Mont.) last week and the selection of the "very liberal former Senate warhorse" Tom Daschle to become the new HHS secretary, a Journal editorial states. According to the editorial, "the reality is that the Baucus-Obama plan would be extraordinarily expensive as it slowly but relentlessly grew the government's share of health spending." The editorial concludes, "Either Senator Baucus and President-elect Obama are making promises that can't possibly be kept. Or they're not being honest about their plans for U.S. health care" (Wall Street Journal, 11/20).

Opinion Pieces

• Elizabeth Carpenter/Sarah Axeen, Philadelphia Inquirer: "While there is no question that the next administration needs to take immediate action to stabilize our financial and housing markets, there is a compelling economic case for keeping health care reform at the top of the agenda," Carpenter and Axeen, who work on health care policy at the New America Foundation, write in an Inquirer opinion piece. They write, "Our economy cannot recover if Americans need to spend a large and increasing share of their income on health insurance," adding, "We know that the uninsured get sick unnecessarily, stay sick longer and are less productive in the workplace." They continue that while there is a "compelling moral case" for reforming the health care system, "making sure every American has quality health coverage is also an economic imperative." Carpenter and Axeen conclude, "The economic and social costs of failing to reform our health system are high," adding, "We must reform our nation's health care system -- not despite our economic crisis, but precisely because of the impact it has on U.S. workers and businesses" (Carpenter/Axeen, Philadelphia Inquirer, 11/20).
  
  
• John Merline, USA Today: President-elect Barack Obama's vow to cut health insurance premiums by $2,500 a year is "one campaign promise [he] is virtually guaranteed to break" because the math that the campaign used to come up with that number was "fuzzy," Merline, a former editorial writer for USA Today, writes in an opinion piece. Even if Obama is able to reduce health care spending by $81 billion through efforts aimed at improving disease management and care coordination, "he'd still be hard-pressed to deliver those premium cuts, because other parts of his plan would almost certainly drive up costs," Merline writes. He concludes, "Obama's promise that he can deliver more health care to more people while painlessly cutting costs is just not possible. At least, not in the real world" (Merline, USA Today, 11/20).

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