In­sur­ers aid fight against Calif. bal­lot ini­tia­tive

Modern Healthcare - - REGIONAL NEWS - —Paul Demko

A po­lit­i­cal bat­tle looms over whether reg­u­la­tors in the na­tion’s most pop­u­lous state will have the author­ity to re­ject pro­posed health in­sur­ance rate in­creases, a power that could make a dif­fer­ence in the fate of the Oba­macare in­sur­ance ex­changes.

Sup­port­ers of the ref­er­en­dum ar­gue that it’s a long over­due mech­a­nism to rein in un­rea­son­able rate hikes and sup­ple­ment changes that were part of the Pa­tient Pro­tec­tion and Af­ford­able Care Act. The mea­sure, which re­ceived enough sig­na­tures in 2012 to qual­ify for this Novem­ber’s bal­lot, would re­quire a sworn state­ment by health in­sur­ers as to the ac­cu­racy of in­for­ma­tion sub­mit­ted to the state in­sur­ance com­mis­sioner to jus­tify rate changes. It pro­vides for pub­lic no­tice, dis­clo­sure and hear­ing on health in­sur­ance rate changes, and sub­se­quent ju­di­cial re­view. It ex­empts em­ploy­ers’ large group plans, un­less the rate in­crease ex­ceeds 10%.

It’s go­ing to be a mul­ti­mil­lion-dol­lar bat­tle. The in­sur­ance in­dus­try, which has the sup­port of the Cal­i­for­nia Med­i­cal As­so­ci­a­tion and the Cal­i­for­nia Hospi­tal As­so­ci­a­tion on this is­sue, is pour­ing re­sources into a vig­or­ous cam­paign to de­feat the bal­lot ini­tia­tive. They ar­gue that it will add un­nec­es­sary time and cost to a process that’s al­ready reg­u­lated by two state agencies. In ad­di­tion, they note that the state’s in­sur­ance ex­change, Cov­ered Cal­i­for­nia, al­ready has the author­ity to de­ter­mine which in­sur­ance prod­ucts are sold through the on­line mar­ket­place. Oth­ers see the need for the changes. “In Cal­i­for­nia, we’ve been in­flicted with dou­ble-digit rate in­creases each and ev­ery year over the last 10 years,” said Dave Jones, Cal­i­for­nia’s in­sur­ance com­mis­sioner and a backer of the bal­lot mea­sure. “Rates have gone up de­spite the im­ple­men­ta­tion of the Af­ford­able Care Act and will con­tinue to go up in Cal­i­for­nia un­less this re­form is en­acted.”

The main group op­pos­ing the bal­lot ini­tia­tive, Cal­i­for­ni­ans Against Higher Health­care Costs, has raised $13.4 mil­lion, ac­cord­ing to the Cal­i­for­nia sec­re­tary of state’s of­fice. The bulk of that money—$12.7 mil­lion—has come from in­surer wel­lpoint and its af­fil­i­ate, An­them Blue Cross.

“We all agree that con­trol­ling health­care costs is im­por­tant, but we can’t make ir­re­spon­si­ble changes to a com­plex sys­tem with­out think­ing through the reper­cus­sions,” said Robin Swan­son, a spokes­woman for Cal­i­for­ni­ans Against Higher Health Care Costs, to whom wel­lpoint and other in­sur­ers re­ferred ques­tions.

Sup­port­ers of the mea­sure have raised only about $425,000 as of April 8, ac­cord­ing to Map­light, a non­par­ti­san re­search or­ga­ni­za­tion. “We ex­pect the health in­sur­ers and HMOs to spend ob­scene amounts of money to mis­lead vot­ers about the bal­lot mea­sure,” Jones said.

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