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August 05, 2008

California Takes Another Crack at Insurance Reform

After a failed attempt to pass a universal health plan early this year, California is now looking to rein in the notoriously consumer-unfriendly market for California individual health insurance.

States face a Catch 22 when it comes to health policies that people buy on their own. Require plans to provide certain benefits or bar them from rejecting individuals for health insurance coverage, and the result will be that the insurance gets more expensive. Give insurers lots of latitude about who and what to cover, and cheaper plans are available — but often not for the older and sicker patients who need coverage most.

So California is trying a balancing act. A proposal being considered in the legislature would require insurers to cover physician services, hospital care and preventive services, and would set a maximum amount patients would have to pay each year toward their bills, the Los Angeles Times reports. State regulators would sort policies into categories based on the health care benefits they offer and establish minimum benefits for each category, presumably making them easier to compare.

But Gov. Arnold Schwarzenegger wants to limit it to categorizing plans and not order insurers to offer specific benefits. Daniel Zingale, the governor’s senior advisor on health, told the Times that although “we need to make the insurance market more user-friendly,” too many benefit requirements could lead to price changes for people who already have coverage.

Sen. Darrell Steinberg, the bill’s Democratic author, told the Times he was “always willing to consider compromise” but that he also would like “the bill to be meaningful to consumers.”

Other ideas being negotiated include limiting limit insurer profits on individual insurance plans and restricting insurers’ ability to cancel policies retroactively.

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Posted by healthinsurance at August 5, 2008 12:05 PM