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State Coverage Model No Help for Uneasy Insurance Industry

In reasserting his support last week for a new government health plan for the uninsured, President Obama stoked the fears of private insurers that they would not be able to compete with a Medicare-like option and might gradually be priced out of existence
In reasserting his support last week for a new government health plan for the uninsured, President Obama stoked the fears of private insurers that they would not be able to compete with a Medicare-like option and might gradually be priced out of existence. The Obama administration has sought to reassure the industry, with its substantial lobbying might, by pointing to the three dozen states that offer their employees a choice between government-backed insurance options and a menu of commercial policies. But health policy experts are deeply divided about whether the state employee plans bear any meaningful resemblance to the public plan options being considered in Washington. And that divide reinforces how little can really be known about how a government plan may fare in competition with private carriers, and whether it may eventually evolve into the country’s lone health insurer. Although state governments bear the ultimate financial risk for their self-insured employee plans, most are administered by major commercial insurers that are given broad authority to negotiate payment rates with doctors and hospitals. In addition, the state plans typically have not used their purchasing clout to control costs, link pay to medical performance or drive other quality improvements.
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