If You Think You Can Cozy Up to the Price Control Oven and Come Out with A Tan Instead of a Burn You Are Mistaken!

Editor’s Note ; The  following statement in Inside Health Policy suggests that the insurance industry does not agree with the above caption written by CRE.  (Re: a meeting of the insurance industry with the White House)

“Kansas Insurance Commissioner Sandy Praeger described Monday’s meeting as “productive” and general. Participants did not wade deep into the specifics of the health reform implementation effort or the regulations released Monday, she said, but agreed broadly on the need to work together to implement the new law effectively. She said all participants agreed in spirit to cooperatively tackle “underlying” health care costs.”

Insurers Welcome NAIC Call For HHS, States To Weigh Transition Plan For MLR

Inside Health Policy

The health insurance industry welcomed a comissioners’ subgroup for proposing HHS consult with individual states to determine if insurers should be given extra time to meet the health reform law’s requirement that a certain percentage of premiums collected to towards actual medical costs — known as the medical loss ratio requirement (MLR).

A National Association of Insurance Commissioners subgroup on Monday gave preliminary approval to a resolution recommending that the HHS secretary consult with each state’s insurance commissioner to determine if she should adjust the MLR in that state during a transition period in order to prevent market destabilization. The health reform law allows the HHS secretary to provide insurers in given states additional flexibility to meet the requirement to avoid destabilizing the market.

De Facto Federal Price Controls are Here — Well at Least in One of the Nation’s Largest States: The Emergence of a Single Payer System ?

Editor’s Note:  See “Comments” section below as well as this post.

 CRE has been on record since the passage of the new healthcare legislation that Section 1003 of the statute is the most onerous and trumps all others in importance. To this end, CRE has developed this Interactive Public Docket dedicated  solely to  this topic.

CFPB Methodology

CFPB Paper

Alternatives to Price Controls for Health Insurance

Some members of the healthcare community  believe  that the regulatory structure in the new health act confers an expost quasi- price control authority to the HHS insurance office.  However it should be noted that although  Congress addressed federal  premium review it  also granted considerable discretion  to HHS  to move towards  a joint federal -state partnership (with an emphasis on state)  for the review of premiums  because of the historical presence of state regulation which is  strengthened by an agressive federal grant program to state regulators.  Executive Order 12886 requires HHS to make a finding of compelling need prior to moving toward the federal price control scenario.