QUESTION II – How will this proposal expand access and increase affordability in the private insurance market?

The private insurance market is inaccessible and unaffordable to many consumers.  There are a number of policy levers that can be "pulled" to alter a state’s insurance market, and make it easier for people with significant health costs to access insurance.  However, some of these changes may also increase costs for younger, healthy people.  It is important to weigh all possible effects when proposing reform ideas.

Most of these insurance reforms can be implemented on the entire market or on one part of the market—that is, the small group market or individual (or nongroup) market.  Targeted reform may allow for reduction in premiums for a certain part of the population.  However, reforming only one segment of the market may distort the greater insurance market.  Most of these reforms are not mutually exclusive; a number of them work well together to reduce premiums.

1. Should insurance carriers be required to sell all people coverage, regardless of health status?
   Click here for more information on guaranteed issue.
   1. If you propose guaranteed issue in the nongroup market, how will you address adverse selection?
      
   2. If you do not propose guaranteed issue, consider a high-risk pool or improvements to your state’s existing high-risk pool.
      For state examples of high risk pool, click here.
   3. Would you prohibit insurance carriers from varying premiums based on factors such as health status, gender, and age?
      
2. Will you prohibit insurers from excluding coverage for pre-existing conditions?
   
   1. Do you want to require all insurers to charge equal premiums to all consumers?
      For more information on community rating, click here.
      
   2. If community rating faces too much opposition, would you propose tightening rate bands?
      
3. Consider additional strategies for increasing access to private insurance.
   Click here for more information on strategies to increase access to private insurance.
   
   1. Consider merging the small group and nongroup markets.
      
   2. Consider allowing sole-proprietors and self-employed persons purchase insurance in the small group market.
      
   3. Consider regulating medical underwriting more heavily.
      
4. Would you propose extending dependent coverage to a higher age?
   
5. Will you require employers to offer employees the opportunity to purchase their health benefits on a pre-tax basis through Section 125 plans?
   
6. Will you use a state-sponsored reinsurance pool to stabilize or reduce premiums?
   
7. Would you support the creation of a comprehensive standardized benefit package for private insurance plans?
   
8. Do you want to set medical loss ratios?
   
9. Would you support creating a health insurance Connector mechanism?
   Click here for more information on Connectors.