Recording and written materials of AIS's audioconference on June 18, 2009

Individual Mandate and Guaranteed Issue: What Plans Can Do to Prepare for the Potentially Enormous Changes Ahead

A number of health reform proposals in Congress would require all Americans to obtain health insurance and require insurers to accept any applicant regardless of health status using adjusted community rating. These rules, which could dramatically change the health insurance landscape, are gaining broad support that includes AHIP and other insurance industry leaders. With the likelihood of passage now greater than ever, it is important to identify practical steps health plans can take to prepare for the potentially enormous market changes ahead.

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Proponents of guaranteed issue and an individual mandate say pairing the two regulations would eliminate the need for insurers to underwrite risk and would force health plans to compete on price, clinical value and consumer satisfaction. Insurance trade group America’s Health Insurance Plans (AHIP) has called for the adoption of such rules. And guaranteed issue and individual mandate rules were included in the Senate Finance Committee’s May 11 summary of health policy options. But there is contentious debate over how new mandate and issue rules would be structured — and great uncertainty about their effect on 50 different state insurance markets.

Two leading health policy experts discuss the likely impact of guaranteed issue and individual mandate rules, and what health plans can do to prepare for their possible adoption. You’ll get valuable practical intelligence on such questions as:

 

Speakers

ROSEMARIE DAY is deputy director and chief operating officer of the Commonwealth Health Insurance Connector Authority, an independent authority established under Massachusetts’ groundbreaking 2006 health reform legislation to promote coverage of the uninsured. Day brings over 12 years of leadership experience in Massachusetts state government to the Connector.  She served as the chief operating officer for the MassHealth program, which provides Medicaid coverage to 1 million people in Massachusetts.  Prior to that, she ran the state’s Child Support Enforcement Program, served as an assistant secretary for the Massachusetts’ Executive Office for Administration and Finance, and was the budget director for the Department of Transitional Assistance. Prior to joining the Connector, Day served as chief of staff to the dean of the John F. Kennedy School of Government at Harvard University. She graduated from the Kennedy School in 1992 with a Master in Public Policy, and holds a Bachelor of Arts degree in Public Policy from Stanford University.

KEVIN WREGE is president of PULSE Issues & Advocacy LLC and a consultant to the Council for Affordable Health Insurance. PULSE provides a range of state and federal advocacy, research and policy services with an emphasis on insurance and general business issues. Wrege is a licensed attorney and a registered Washington, D.C., lobbyist. Prior to forming PULSE, he served for four years as regional director and then senior regional director at America’s Health Insurance Plans, overseeing all of AHIP’s legislative and regulatory affairs in several mid-Atlantic and southeastern states. Before joining AHIP, Wrege served as general counsel to the cable division of the Massachusetts Department of Telecommunications and Energy and as senior counsel to the Massachusetts Division of Insurance. He received his Bachelor of Arts degree in Political Science magna cum laude from Hobart College and a law degree from Boston College Law School.

Moderator: Jill Brown, Contributing Editor, Health Plan Week

 

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Written Materials

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