Rep. John Dingell has filed a “manager’s amendment” to the main House health bill that could affect health insurers’ ability to increase rates starting in 2010.
Dingell, D-Mich., is one of the lead sponsors of H.R. 3962, the 1,990-page Affordable Health Care for America Act bill.
The manager’s amendment to the AHCAA bill will add another 42 pages.
For health insurers, one amendment section of interest is Section 104, which relates to “Sunshine On Price Gouging By Health Insurance Issuers.”
The section authorizes the U.S. secretary of Health and Human Services to work with the states to set up a process for reviewing proposed health insruance rate increases starting in 2010.
“Such process shall require health insurance issuers to submit a justification for any premium increase prior to implementation of the increase,” according to the amendment text. “Such issuers shall prominently post such information on their websites. The Secretary shall ensure the public disclosure of information on such increases and justifications for all health insurance issuers.”
If a state insurance commissioner finds that a health insurer has a pattern of imposing “excessive or unjustified premium increases,” the insurer could be shut out of the proposed “health insurance exchange” program, according to the amendment text.
H.R. 3962 calls for using a new health insurance exchange system to help individuals and small groups shop for standardized health insurance plans. The exchange also would help administer a health insurance premium subsidy program.
The Section 104 provision would let the HHS secretary give states up to $1 billion in rate review program grants during a 5-year period that would start in 2010.
Here are some of the other provisions in the manager’s amendment:
- Section 555, which starts on page 14, would create a “second generation biofuel producer credit.” The credit would actually raise about $24 billion over 10 years, because the value of the credit would be more narrowly pegged to the value of the biofuel being produced than the existing biofuel producer credit is, according to Rep. Chris Van Hollen, D-Md., who has put the proposal in a stand-alone bill, H.R. 3985.
- A section that starts on page 9 appears to incorporate the text of a measure proposed by Rep. Dan Lungren, R-Calif., that would limit the effects of a health care antitrust provision. The provision would block health insurers and medical malpractice insurers from using the insurance industry antitrust exemption in the McCarran-Ferguson Act. The Lungren measure would ensure that insurerers could continue to work together to collect historical loss data and determine loss development factors based on historical loss data. Actuaries could perform actuarial services if doing so did not involve restraint of trade.
- Section 2538, which starts on page 31, calls for the HHS secretary to establish a program that would provide mental health screening, treatment and referral services for individuals in primary care settings. The HHS could create and run the program by awarding grants to, or entering into contracts or cooperative agreements with, a “public or private nonprofit entity” that “provides primary health services” and “seeks to integrate mental health and substance abuse services into its service system.”
- Section 1707A, which starts on page 35, would have the government create offices of minority health at the U.S. Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Agency for Health Care Research and Quality, the Health Resources and Services Administration, and the Food and Drug Administration.
- Section 2594, which starts on page 39, would start a diabetes screening collaboration and outreach program that could involve trade groups and professional societies.