2007 House Bill 5282

Revise individual health insurance policy regulations

Introduced in the House

Oct. 11, 2007

Introduced by Rep. Virgil Smith (D-7)

To establish a Blue Cross Blue Shield guaranteed issue high-risk health insurance pool whose maximum premium price would be capped, and levy a fee on other health insurance companies to recoup the cost of insuring individuals in the BCBS pool. Under current law, Blue Cross is required to accept all applicants regardless of prior conditions, in return for which it is exempted from all state corporate and property taxes. Under the bill BCBS would retain its tax exemption and also be allowed to pass on the extra cost of covering these high risk individuals to companies that are not exempt from state taxes. Health insurers would not be prohibited from denying coverage to very high risk individuals, but through the levy ultimately would bear the cost anyway, despite their taxable status. The bill would also impose price controls on individual health insurance plans in the form of “rate bands” that limit the difference between the highest and lowest premiums for a certain level of coverage regardless of the risk represented by an individual, and would limit the ability of insurers to set rates based on a person's geographic region.

Referred to the Committee on Insurance

Oct. 17, 2007

Reported without amendment

Without amendment and with the recommendation that the bill pass.

Oct. 24, 2007

Substitute offered by Rep. Barbara Farrah (D-13)

To replace the previous version of the bill with one that revises details but does not change the substance of the bill as previously described.

The substitute passed by voice vote

Passed in the House 89 to 17 (details)

Received in the Senate

Oct. 25, 2007

Referred to the Committee on Health Policy

May 1, 2008

Substitute offered

To replace the previous version of the bill with one that would not create the state “high risk insurance pool” of the House-passed version.

The substitute passed by voice vote

Passed in the Senate 23 to 13 (details)

To impose new regulations on providers of health insurance policies for individuals (as opposed to groups or employees). Commercial insurers would be required to provide coverage to an individual with pre-existing medical conditions not longer than six months after the person applies (under current law the time is 12 months). Providers would be prohibited from not renewing an issued plan based on a customer’s claims experience, and price increases based on health status changes would be limited. The bill also allows insurers to give discounts to customers who don’t smoke or participate in certain “wellness” programs; and imposes a limit of 60 percent on the aggregate benefits paid out vs. the premium revenue, with customer rebates for any excess. The bill does not create the state “high risk pool” of the House-passed version. See also House Bill 5283.

Received in the House

May 1, 2008

June 27, 2008

Failed in the House 26 to 79 (details)

To concur with a Senate-passed version of the bill. The vote potentially sends the bill to a House-Senate conference committee to work out the differences, if possible.