While much of the current debate over health care reform is in Washington, D.C., where members of Congress are debating a number of proposals to repeal and replace significant elements of the Affordable Care Act (ACA), it is important to remember that the states remain the primary regulators of the insurance industry. In particular, states have authority to determine which entities and individuals are licensed to sell insurance, determine what insurance products enter the market, impose solvency standards, establish consumer protections, and enact various other laws and regulations affecting the industry. Depending on what health care reform legislation is enacted at the federal level, the states may have even greater flexibility to shape their respective health insurance markets.
However, some states are not waiting for Congress to address this issue and are moving forward to enact broad, sweeping changes to the health insurance market. In one instance, California is considering legislation to establish a single-payer healthcare system that would cover all medical expenses for all residents in the state. Under the California proposal, individuals covered under Medicare or Medicaid and those insured through the private individual or group market would lose their current coverage and would instead be covered under the single-payer program. Other states, such as Nevada, are considering related proposals that would greatly expand the state’s Medicaid program by amending the eligibility standards to permit significantly more individuals to enroll. Other states may consider undertaking similar efforts in the months and years ahead.
In almost every legislative session, there will be many state proposals designed to further increase the accessibility and affordability of health insurance. NAIFA supports initiatives that foster a robust and competitive private market to offer employers and individuals ample coverage options to meet their health care needs. NAIFA will advocate on behalf of its members to ensure that choice, quality, competition, and access to professional service be a part of any health care reform effort.