Modern Healthcare

Insurers aid fight against Calif. ballot initiative

- —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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