Drama at DisneyWorld, NAIC Edition…

I’m writing this from Orlando, FL. Unfortunately I’m not at Disney World. I’m at the fall meeting of the National Association of Insurance Commissioners (NAIC) in Florida. Here’s why:

I am one of about a dozen consumer representatives appointed to represent consumers as the NAIC works on the rules to implement health care reform. Within the next 24 hours the insurance commissioners here from each state will vote on a key consumer provision with the crazy name of the ‘Medical Loss Ratio’ or MLR. This provision in essence requires insurance companies to spend at least 80 or 85 percent of the premiums they collect on actual health care for their consumers.

The NAIC has had an open and consultative process with states, industry, and consumer advocates over the last 5 months to develop the policy. They have crafted such a compromise policy and the commissioners will be voting to approve the policy in the next day in Orlando.

Now at the literally last minute, the industry has mounted a concerted lobbying campaign to substantially weaken this policy to make it more favorable to the insurance companies. The industry has raised issues that have already been decided months ago for reconsideration this week. They have asserted that these restrictions are unfair to the industry and insurance companies should not have to spend 80 or 85 percent of their premium dollars on real health care (even though this is in the new law.) The insurance companies want the freedom to spend their premium dollars on executives’ salaries, marketing, brokers’ commissions, advertising, and profit–not consumers’ health care.

Consumer representatives have mounted a counter offensive to get the insurance commissioners to vote on the side with consumers. We won’t know for a day or so what the outcome will be, but the stakes are high.

UPDATE: Here’s more details from my fellow NAIC consumer representative Wendell Potter, writing in the Huffington Post.

Health Access California promotes quality, affordable health care for all Californians.

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