For the second year running, health care wins hands-down as the most important issue that regulators and legislators will face in 2008, according to interviews with National Underwriter.

There will be a big effort to be involved in solutions to provide broader health care options, says Sandy Praeger, Kansas insurance commissioner and the new president of the National Association of Insurance Commissioners, Kansas City, Mo. State regulators can help in this area, she says, because health insurance is a very localized issue.

She notes that states have helped with health policy in the past, such as the development of the Health Insurance Portability and Accountability Act.

For instance, state insurance regulators can be a resource to presidential candidates, she says, but adds that NAIC will be “apolitical” and will provide information “only if asked.”

Praeger says regulatory modernization in areas such as producer licensing will also continue. And, going forward, NAIC will look at ways to work more with federal regulators, she says.

Utah Insurance Commissioner Kent Michie agrees that “health care is the number 1 policy issue facing us.”

The NAIC can help bring this debate into “full light” by providing good data, Michie says. “We owe it to share the expertise that we have.”

If Congress decides to pursue an optional federal charter, he says, there needs to be ways for both state regulators and federal officials to work together. Both have strengths, he says. The federal government does not have the organization or staff to enact bills that pass, while states have strength in those areas, he adds.

Both Joel Ario, Pennsylvania insurance commissioner and chair of the NAIC’s “B” Health Committee, and Jane Cline, West Virginia insurance commissioner and NAIC vice president, say that states can act as laboratories in the development of new health care initiatives. Cline says that in her state, access to health care solutions for the uninsured is an important issue.

Another initiative that Cline says she will focus on in 2008 is the continued development of the Interstate Insurance Product Regulation Commission, with the addition of product filings.

The effort to advance a project that would create principles-based reserving for life insurance and health insurance products is another regulatory item that will receive a lot of attention in 2008. The focus in the first part of the year will be on completing the Valuation Manual that will be the guidebook for reserving under the new system as well as an effort to advance a revised Standard Valuation Law, says Thomas Hampton, commissioner of the District of Columbia.

Kim Holland, Oklahoma insurance commissioner, also notes the importance of PBR initiatives going forward in 2008 in addition to issues pertaining to global regulation. These include collateral that reinsurers outside of the U.S. would have to establish as well as international accounting standards.

Members of the National Conference of Insurance Legislators, Troy, N.Y., will be tracking a number of issues in 2008, according to the organization’s new president, state Rep. Brian Kennedy, D-Hopkinton, R.I., and Susan Nolan, NCOIL executive director.

Front and center, says Kennedy, will be an effort to try and enact a model NCOIL has just passed that attempts to stop stranger-originated life insurance transactions. In addition, he says, NCOIL will also attempt to get more states to support its market conduct model. Kennedy adds that the organization will also continue to pursue his goal of ensuring that meetings at the NAIC are open. Health reform will also be a focus for state insurance legislators, according to Kennedy.

NCOIL will also track what the NAIC, and the states of Florida and New York are doing on the reinsurance collateral issue, says Nolan.