Managed Care - March 2010 - (Page 23)
Many States Preparing Laws Rejecting Individual Mandate The most attractive element of the congressional reform plan — at least in the eyes of insurers — is drawing fire in at least 30 states By early February, Virginia’s Legislature took the lead among states preparing to man the barricades against the individual mandate. The Republicanhen representatives of the managed led House endorsed a measure approved by the care industry took their place at the Democrat-dominated Senate that would exempt bargaining table to help hash out a state residents from an insurance mandate and health reform bill last year, there was one clear quid Gov. Bob McDonnell, a Republican, was expected pro quo: Insurers would agree to stop evaluating to quickly sign it. preexisting conditions when they set premiums in “The election of Scott Brown accelerated exchange for a government mandate requira lot of these proposals,” says Christie Hering people to get coverage or face a penalty. rera, director of the health and human servOpportunity seen ices task force of the American Legislative Exchange Council (ALEC), which has coorIndustry leaders reasoned that they could dinated the nationwide effort. afford to forgo an evaluation of individual “Virginia and other states are back in play. risk factors and help keep premiums affordAnd it’s not just a federal-state conflict. This able if a law could draw in 30 million new members, including many who would qual- “It’s immoral to be is an effort by these legislators to stop a Massachusetts-style initiative.” ify for public subsidies. forced to purchase “The reality is that it was a very political But while most of the discussion was in a product you discussion,” says Doug Gray, executive diWashington, D.C., state legislators around might not want or need,” says Christie rector of the Virginia Association of Health the country began listening to reform oppo- Herrera, of the Plans. “The message to Washington is that nents, and Republicans and conservative De- American Legislathey didn’t like their reform bill. The federal mocrats alike have found common cause in tive Exchange debate turned things against reform.” targeting the individual insurance mandate. Council. Gray adds that fine points regarding such Richard Cauchi, the health program diconcerns as what happens to universal coverage rector for the National Conference of State Legisand health care costs when you don’t mandate covlatures, says that by last count in mid-February, at erage were not even discussed. least 32 state initiatives had been filed that were inspired by federal health reform — most of them Tooth and nail aimed at the individual mandate. Throughout the course of last year, legislatures Requiring people to obtain coverage, says Amerfrom coast to coast began to argue the constitutional ica’s Health Insurance Plans, is an essential step to implications of forcing people to buy insurance. And gaining universal coverage and making insurance the issue has been steadily building steam, reaching affordable for everyone. CEO Karen Ignagni the boiling point around the time reform-opponent fought tooth and nail against proposals to weaken Scott Brown was elected to fill Ted Kennedy’s Senate the penalties for anyone who chose not to particiseat representing Massachusetts, the state that gave pate, calling it a “powerful incentive for people to birth to the original individual insurance mandate. wait until they are too sick to purchase coverage.” “I was adding a state every day for two weeks at Without a strong mandate, the Oliver Wyman one point,” says Cauchi. consulting company said last fall, millions of By John Carroll W MARCH 2010 / MANAGED CARE
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