If there’s one thing the National Association of Insurance Commissioners don’t see much of, it’s public attention. Now, however, it’s got the attention of the media, consumer advocates and at least part of an increasingly aware public. The spotlight may lead them to better decisions, even though insurance company lobbying has not diminished a bit.
The NAIC is finishing up its first proposals for regulations that will bring health reform to life–the new health law’s requirement that insurance companies spend from 80% to 85% of premium dollars on health care–and less than they spend now on overhead, profit and marketing. That greater efficiency, if it occurs, would help bring down the insurance premiums, or at least curb recent double-digit increases.
No one can tell whether the regulations will actually do that. The proposals so far give away a lot to insurers, allowing them to magically count a lot of former administrative duties as health care: even their "accreditations"–meaning a certification of financial health–get counted as health care in the latest proposal. But from what I hear, it could have been a lot worse, and the public openness of the process gets a lot of credit, along with steady pressure from consumer advocates both inside and outside the organization.
The commissioners will vote tomorrow on their first batch of regulatory proposals, and pass them along to the Department of Health and Human Services. If the votes have no surprises, sunshine gets credit for a small victory.
What the NAIC should do now, before these rules are set in stone, is to measure what they’ll accomplish. Its actuaries should apply the new rules to the last three years of insurance company financial reports, and tell us if the giveaways are forcing the insurance companies to change anything at all.They don’t have to wait until every proposal is approved–give us a running tally!
If a combination of new tax deductions and concessions on what "health care" means add up to even a 5% or even 3% shift in measuring the proportion spend on health care, the whole effort of birthing these regulations may mean nothing. But we’ll never know unless someone with access to the information and the tools to measure the change gives us some answers.
We’ll know more tomorrow about the what the proposed recommendations say, but we need hard data on what they’ll actually do.