Drafters of a National Association of Insurance Commissioners (NAIC) health insurance exchange white paper should give an example of what can go wrong when states adopt guaranteed issue laws without establishing open enrollment periods.
C.M. Gallaher, a vice president at America’s Health Insurance Plans (AHIP), Washington, makes that suggestion in a comment letter submitted to the National Association of Insurance Commissioners (NAIC), Kansas City, Mo.
The Exchanges Subgroup at the NAIC has been developing white papers that would give state insurance regulators’ regulators views on implementation of the section of the federal Patient Protection and Affordable Care Act of 2010 (PPACA) that call for the creation of a new system of health insurance exchanges.
Starting in 2014, the exchanges are supposed to distribute subsidized health coverage to individuals and small groups.
That same year, PPACA is supposed to require all major medical insurers to sell coverage on a guaranteed-issue, mostly community-rated basis.
One of the NAIC Exchanges Subgroup white papers deals with “adverse selection,” or the risk that some insurers will end up assuming more than their fair share of risk, in a way that will end up destabilizing local markets, state markets or the national market.