Congress must weigh the cost of every proposal as it seeks to reform the health insurance market.

Janet Trautwein, executive vice president of the National Association of Health Underwriters, Arlington, Va., made that plea today at a health care conference organized by members of the Senate Finance Committee.

Lawmakers should consider “not just whether or not the market reform idea includes cost containment elements, but also whether or not the market reform idea itself would cause health insurance premiums to increase,” Trautwein said.

An idea that seems “fair” may not be so fair if it pushes rates up and forces some who now have health coverage to drop their coverage, Trautwein said.

Trautwein was one of four health care experts who spoke at a conference session chaired by Sen. Jay Rockefeller, D-West. Va., and Sen. Orrin Hatch, R-Utah.

The conference keynote speaker was Ben Bernanke, chairman of the Federal Reserve System Board of Governors.

Rising medical costs are likely to restrict access to health care for lower income people, because both doctors’ fees and health insurance will become unaffordable, Bernanke predicted.

As costs rise, the government may have to absorb an increasingly large share of the bill, Bernanke said.

That shift will put “even greater pressure on government budgets than official projections suggest,” Bernanke warned.

Also at the conference:

- Small employers face increasing pressure to pass more health benefits costs on to employee, but most resist doing so, said Reed Tuckson, an executive vice president at UnitedHealth Group Inc., Minnetonka, Minn.

- Stuart Butler, a vice president at the Heritage Foundation, Washington, said the best approach to achieving health system reform goals is through a “bottom-up evolution,” not a “top-down revolution.”

States should form health insurance exchanges that resemble the Federal Employee Health Benefits Program, Butler said.