KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Need For Federal Insurance Czar Is Questioned

"Health care overhaul legislation from President Barack Obama's congressional allies would create a federal insurance czar with sweeping new powers to oversee medical plans nationwide, an idea already drawing fierce criticism," The Associated Press reports. "State insurance commissioners are objecting, saying it would duplicate what they now do without offering any better protection for consumers. Conservatives are calling it a textbook example of a big government mentality."

"The insurance czar, known as the Health Choices Commissioner, would head a new independent agency called for in the 800-page draft bill released by House Democratic leaders. The Health Choices Administration would regulate a revamped insurance marketplace and be expected to deliver Obama's promise of affordable coverage for all." State insurance commissioners, "who traditionally have overseen the health insurance industry" say the state regulatory system works the way it is, but the Consumers Union counters that "not every state does a good job of overseeing the insurance industry." Conservatives say the health czar proposal is "a federal power grab."

"The commissioner and the health choices agency would oversee something called the health insurance exchange. That's a new kind of national purchasing pool through which individuals and small businesses could pick medical coverage from a range of private plans and a government-sponsored alternative. The House legislation would eventually open up the insurance exchange to all employers. The commissioner would get to decide when that happens." Responsibilities would include determining "who qualifies for federal subsidies to help buy coverage," setting "standards for handling grievances and appeals for claims denied," determining "plan benefits for each year," policing "insurance marketing campaigns," and enforcing "a requirement that the insurers spend on medical care at least 85 percent of what they collect in premiums." It is not known "whether the Senate will follow the House's lead on the federal health insurance czar. Senators are talking about setting federal standards for health insurance, but delegating enforcement to the states" (Alonso-Zaldivar, 7/7).

Meanwhile, polling data shows widespread support for Obama's national health care proposal, "but if history and polling trends are any guide, however, that will change," The Washington Post reports. Pollster Daniel Yankelovich says voters are in the "Wishful Thinking stage," but "in the next few weeks, when voters discover what national health care will cost and how it could affect their own care, romance will give way to reality." In mid-June, a New York Times-CBS News poll found that "Americans favor by more than 3 to 1 'the government offering everyone a government-administered health insurance plan that would compete with private health insurance plans.'" But the polls were completed before the Congressional Budget Office scored Sen. Edward Kennedy's reform bill and found that "the bill would increase the federal deficit by $1 trillion over the next decade yet make only a dent in the number of uninsured." A mid-June poll by the Kaiser Family Foundation had similar findings.

"Health-care reform is going to cost major dollars no matter what, and those dollars will have to be extracted mainly from those most able to pay: the top-earning 40 percent of the population. When these top earners figure out that they're being asked during a recession to shell out more -- through increased taxes, higher insurance premiums or other mechanisms -- for benefits that will go mostly to others, they won't be happy. And that top 40 percent knows how to make itself heard in Washington. This isn't just speculation. Similar scenarios played out in 1993 when the Clintons pushed for their ill-fated health care plan and in 1988 after Congress passed an insurance plan to protect the elderly against the costs of catastrophic illness." The author predicts that only in August "will we discover what citizens truly believe about health care. The result could be far more modest reform than we've been led to expect" (Colvin, 7/7).

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