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The 'Big 3' Fixes for the Weakened Senate Health Reform Bill to Block Full Insurance Co. Take-Over of Health System
Date:12/15/2009

r departure from previous version of the Senate bill, and the House legislation, which bar any annual caps.

The Senate bill cites section 223 of the Internal Revenue Code, which regulates Health Savings Accounts. That section does not define "reasonable" annual limits. As a result, health insurers will be left to define "reasonable" as they see fit. However, for an insurance company, a "reasonable" limit on annual health care costs is one that increases shareholder profits by cutting off access to necessary care.

3. Make Health Insurance Rate Regulation Real

Requiring insurance companies to justify rate increases and seek "prior approval" for those increases are essential components to controlling skyrocketing health insurance premiums, deductibles, and other out-of-pocket costs.

Page 37, section 2794 of HR 3590 provides some additional transparency on insurance premiums and takes some first steps toward limits on insurance company gouging, but does not provide real protections for Americans by, for instance, requiring insurers to seek approval before imposing premium and rate increases.

Consumer Watchdog, which pioneered the most successful insurance premium regulation law in the nation, Proposition 103, calls on the Senate to adopt amendments reflecting key provisions of California's landmark insurance reform law, including:

  • Mandatory justification of any rate increase (including premiums, deductibles, co-pays), not merely justifications of "unreasonable" premium increases.
  • Mandatory prior approval, which means requiring insurers to seek permission from government regulators, in addition to justifying rate increases, before imposing rate increases. Since 1988, California's Proposition 103 has saved drivers $62 billion while fostering a competitive and profitable insurance market.
  • An intervenor system that provides consumers a forum to challenge unnecessary or exce
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SOURCE Consumer Watchdog
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