Members of the Senate Finance Committee may have watered down the individual health insurance purchase mandate in their version of the health reform bill.

The committe is continuing to revise, or “mark up,” a modified version of the America’s Healthy Future Act bill, a health reform proposal developed under the direction of Senate Finance Committee Chairman Max Baucus, D-Mont.

One principle backed by both President Obama and America’s Health Insurance Plans, Washington, is that the health reform bill should include a requirement that health plans accept applicants with preexisting conditions, without charging them higher prices because of their health status, along with a requirement that individuals have health coverage, to protect health plans against the risk of antiselection.

Sen. Charles Grassley, R-Iowa, today proposed an amendment to the AHFGrassleyA bill that would let states opt out of the individual health insurance ownership mandate and switch to other arrangements approved by state insurance commissioners as actuarially sound.

Alternatives to a health insurance plans could include reinsurance programs or “other policies that we haven’t thought of yet,” Grassley, the highest ranking Republican on the Senate Finance Committee, said. “It’s a mistake to think that Washington has all the answers.”

Grassley said he proposed the amendment because he decided during the Senate’s August recess that imposing an individual health coverage mandate would create new problems.

“There is of course a principle of personal responsibility,” Grassley said. “We all one way or another pay for the health care for the uninsured. A mandate helps stabilize premiums, mostly by requiring younger people to buy insurance.”

Moreover, “it’s easy to see why the health insurers want the mandate,” he said. “It’s going to make them a heckuva lot of money.”

But, under the AHFA bill, the government could impose up to $1,900 in new taxes per year on a family that goes without coverage, and the idea of requiring an individual or family to own coverage that meets lengthy federal benefits requirements is ano

ther cause for concern, Grassley said. He also questioned the idea of adopting a program that would create subsidies for families earning as much as $88,000 per year at a time when the United States has a giant budget deficit.

Sen. Ron Wyden, D-Ore., brought debate of the proposed Grassley flexbility amendment to a halt by noting that Baucus already has approved a state flexibility amendment that he has offered. That amendment already would let states go with alternatives to the health insurance mandate requirement, Wyden said.

“I wanted to give [states like Oregon] the maximum amount of flexibility,” Wyden said.

Grassley agreed to hold back on further discussion of his flexibility amendment while he determines whether the Wyden amendment would really do the same thing.

Earlier, members of the committee agreed unanimously to approve an amendment, proposed by Sen. Debbie Stabenow, D-Mich., that would let dental insurers team with medical insurers to offer coverage packages through the proposed health i nsurance exchanges for individuals and small businesses. Earlier, some had suggested that the Baucus AHFA bill might let dental insurers participate in the exchanges only by offering stand-alone plans.

Stabenow said she kept vision coverage providers out of the bill for technical reasons.

Grassley noted that Iowa dental providers have talked to him to ask him where they would stand in the health exchange system.