Particularly in California, where denials of coverage have become almost a cottage industry, the individual health insurance market is in trouble. Now, leading health industry trade America's Health Insurance Plans has created a proposal which might address some of its problems. The proposal was developed with the help of several large health plans, including Kaiser Permanente and Health Net, who doubtless hope to stave off harsher regulations that might emerge under coming health reforms.
The proposal, among other things, would make it harder for insurers to cancel individual policies or screen out people with pre-existing conditions, while cutting premiums typically charged to such beneficiaries. It would also take on the issue that's pitting California regulators against many large health plans, suggesting that decisions to rescind coverage by subject to third-party reviews. However, not surprisingly, it stops short of banning the forms of rescission which are at issue in battles between regulators and plans like Blue Cross of California.
In return for its beneficence, AHIP would like to see the states create some sort of last-ditch coverage for people with medical costs which are expected to be twice the average. Meanwhile, the industry would cap premiums at 150 percent of market rates for high-risk patients who didn't meet this standard.
To learn more about the proposal:
- read this piece from The New York Times
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