Nunez Health Reform Bill Establishes Mandatory Purchase Without Linking to Subsidies for Middle Clas...(8will likely be amended into the final b...),Health

-- Affordability -- lack of price controls. Unlike the auto insurance market under Proposition 103, AB 1X1 does nothing to limit insurer's rate increases, an omission that is already undercutting Massachusetts' health care reforms. During the last seven years health insurance premiums have increased three to four times faster than medical inflation.

-- Guaranteed issue -- no true community rating. AB 1X1 purports to limit an insurance company's premium cost variation for individual policies to "age, family status, and geography," but unlike rules in the employer market, nothing further is provided to define those categories. This is particularly important to older consumers. Under the current wording, insurers could impose annual, bi-annual, or even quarterly premium increases based on age.

-- Universality -- no defined benefit. Promising comprehensive coverage while guaranteeing none is not something voters will accept. AB 1X1 punts the key decision about what Californians will receive when they buy health policies until after the bill is passed, leaving tough choices to state bureaucrats more likely to settle for less than legislators, because they are insulated from voter outrage. The required coverage could exclude essential services including emergency care, hospital and physician coverage, vision and dental.

-- Universality -- no defined benefit. By exempting from the mandate those who would have to spend more than 6.5% of family income, AB 1X1 all but assures that regulators will define a policy that fits the 6.5% rule, but provides only an illusion of coverage. This has been the experience in Massachusetts, the only state to adopt a mandatory purchase requirement. If not forced to buy a cheap "junk insurance" policy, the alternative for such families would be to remain uninsured.

-- Rigidity of Choice -- locking patients in low-benefit coverage. Five different plans may be an
'/>"/>