FIXING THE GAME
Ideas from the insurance industry and its supporters
Fixed Rule:
America's Health Insurance Plans (AHIP) wants states to let insurance companies offer plans that do not provide all mandated benefits.
One way America's Health Insurance Plans (AHIP), the trade association of the insurance industry, proposes to increase access to health care coverage is for states to "allow product flexibility so health insurance plans can offer a wide variety of affordable products to consumers. If states establish minimum benefit requirements for purposes of determining an appropriate level of coverage or eligibility for premium subsidies, such requirements should allow health insurance plans to offer policies that do not include all mandated coverage."
That's right, like Senator John McCain, AHIP proposes to increase access to health insurance by selling cheaper health insurance policies that don't cover certain benefits.
What are these benefits that, according to AHIP, people could do without? Many benefits states mandated must be covered are ones that any reasonable person would expect to be covered by their health insurance, such as maternity care, treatment for diabetes, cancer screenings, and emergency services.
The whole point of insurance is to provide financial security in the face of unpredictable events, like getting cancer or having a car accident outside the plan's service area. Insurance should not force you to gamble on the hope that you won't get the disease not covered by your health plan.
Consumer groups across the country have worked with state legislatures for years to ensure that health insurance covers the essential benefits people need. According to the American Cancer Society, doing away with those mandates "would erase all that state legislatures have done to prevent and more effectively treat cancer by ensuring access to life-saving screenings for breast, colon, and prostate cancer, cancer specialists, coverage for evidence-based off-label prescription drug use, clinical trials, and proven smoking cessation services."
The insurance companies that make up AHIP's membership basically want the ability to lure people into buying "cheaper" insurance policies that will leave them completely uncovered when they need them most.
Read other ways the insurance industry and its supporters are trying to fix the game in the "Fixing the Game" archive.
Fair Rule:
- A public alternative to insurance company coverage that is accountable to us.
- Fair regulation and oversight of insurance companies, with government as a watchdog.
Read more in the "Fixing the Game" Archive.
LATEST SCORECARD
Fifty-eight percent of primary care doctors in the U.S. report their patients often have difficulty paying for medications and care, and half of U.S. doctors spend substantial time dealing with restrictions insurance companies place on their patients’ care, according to the 2009 Commonwealth Fund International Health Policy Survey.
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Families saw their premiums for job-based health insurance rise to an average of $13,375 annually in 2009, with workers paying an average share of $3,515 and employers paying $9,860.
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