New York, Wisconsin To Debate Health System Change Proposals

Two newspapers recently published articles detailing the debate in the New York and Wisconsin state legislatures over health care. Summaries of the coverage appear below.

* New York: The New York State Legislature early next year is expected to debate whether the state’s soaring insurance premiums can be better addressed through price controls on insurance premiums or through the current system, which bases premiums on the amount of money insurers estimate they will pay out each year, the Rochester Democrat and Chronicle reports. Supporters of a “prior-approval” system, including Gov. Eliot Spitzer (D), say price controls could address the problem by decreasing profits and spending by insurers, which have “become more financially successful” since price controls were partially lifted in 1996, according to the Democrat and Chronicle. Troy Oeschner, deputy state insurance superintendent for medical insurance, said, “We’re not saying as soon as we get prior approval, rates will become affordable for everybody. But under current law, we really don’t have a way to enforce provisions against the plans gaming the system.” The health insurance industry, which wants to retain the current “file-and-use” system, says that the market should set premium rates and that it would be difficult to keep politics out of a prior-approval system, the Democrat and Chronicle reports. Geoffrey Taylor, a spokesperson for insurer Excellus BlueCross BlueShield, said, “Classically, what happened under prior approval in years past, during election cycles you would see suppression of rates, then afterwards try to catch up, then get sticker-shock prices.” Taylor noted that premium rate increases in New York have been consistent with other states’ increases over the past decade. He said the key to controlling premiums is to slow the growth in prescription drug and medical care costs. The chairs of the state Assembly and Senate insurance committees have said they are open to change, but they are “not committed to it,” the Democrat and Chronicle reports (Gallagher, Rochester Democrat and Chronicle, 8/6).

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