Hot Button Health Reform Issues: The Individual Mandate And Selling Insurance Across State Lines

News outlets report on several of the hot button issues in the health care debate, including the individual mandate and selling insurance across state lines.

Minnesota Public Radio reports on the GOP idea of selling insurance across state lines, which could be debated at the bipartisan health care summit next week. Gov. Tim Pawlenty, R-Minn., talked about the idea in his State of the State address. Currently, states "regulate companies that insure their individual residents and small groups. So, a company that sells health insurance to individuals in Minnesota must get a state license and follow Minnesota's consumer protection laws. But for the past several years, national and state politicians have argued that state regulation has led to less choice and higher prices for consumers, because a few companies dominate the market." In Minnesota, says Pawlenty, three insurers dominate the market.

"Republicans like Pawlenty argue that allowing more companies to enter the market would increase competition and lower premiums," and "the proposal is contained in the health care reform bills." But there is disagreement over how it would work. "Democrats prefer a highly regulated 'health insurance exchange,' a marketplace where consumers who don't have insurance through their employers could comparison-shop for policies. … The reform bills also included a provision that would allow states to make insurance agreements among themselves." Some Republicans simply propose allowing "residents of one state to buy insurance from companies in another state" (Stawicki, 2/16).

Modern Healthcare reports on a new analysis suggesting that mandating that individuals buy health coverage "would be essential to the success of insuring people under the Senate health reform bill." The study, released by the RAND Corp., included "analyses of both the House and Senate reform bills plus a side-by-side comparison of the two bills" and "concluded that the Senate bill would cut the number of uninsured Americans to 25 million by 2019 (a 53% decrease, based on status quo projections) and increase overall national spending on healthcare by about 2% cumulatively between 2013 and 2019." The individual mandate "would play the largest role in increasing insurance coverage; it alone would reduce the number of uninsured by 21.5 million, according to RAND. 'In the absence of penalties for individuals who do not purchase insurance, 10 million more people would be uninsured,' the analysis stated" (Lubell, 2/16).

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