HEARING - U.S. Senate Special Committee on Aging

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53 -5 - STATE HIGH RISK POLS FOR LNINSURWAES We cannot fail to mention that not everyone can buy individual insurance products in the private marketplace. The camiercial health insurance industry has long supported legislation to make health insurance available for persons considered uninsurable in the individual health insurance marketplace. This legislation, S. 1372, 5.2402, and S. 2403 introducted during the 99th Congress by Senators Itinz, Kennedy, and Durenberger, respectively, would encourage states to establish qualified risk pools for uninsurables, incluzing persons unable to buy health insurance coverage due to such chronic health conditions as diabetes, heart disease and AIDS. The industry expects similar legislation to be introduced again this year. Several models for an effective risk pool already exist. Ten states currently have some form of risk pool offering comprehensive major medical insurance to high risk people. The pool operates like any other private insurance plan. If the pool experiences losses, those losses are shared by all the insurers in the state. The pools would be established in the states and regulated Like other state insurance. The federal legislation simply establishes minimum standards based on the experiences of successful state pools and ensures a fair distribution of pool losses. tMst important, the state high risk pool proposals would ensure the availability of health insurance to all Americans, regardless of health condition, with mininun federal regulation, and at no cost to the feceral treasury .
54 -6- MiCIGAP INSJRANCE: A RPL1C/PRIVATE SECTOR SUCCS STORY For the nation's elderly, the HKIA believes that Medicare together with the private health insurance industry ane doing a good job in providing prvtection against the medical costs of acute catastrophic illnesses. We are proud of our record in providing supplemental coverage to the Medicare program so that the Medicare beneficiary can feel confident that his or her acute health care needs will be met in the future. There have been sane assumptions in the past that private insurance is confusing and duplicative. This premise is invalid. A 1983 HCFA study of the effectiveness of state regulation of Medigap insurance found that duplicative coverage was rare. Further, the October 1986 GAO study prepared for the House Ways and Means Health Subcommittee concluded that state regulation of the Medigap business was working well in controlling sales abuses. Of the millions of policies presently in force, we are aware of only a handful of alleged violations brought to the attention of HCFA. Upon investigation, the majority of these cases were closed because they didn't warrant federal action. MCFA coordinates review of alleged violations of federal statutes together with the Federal Trade Camission and the FPstal Service. The HZAA feels that this process is adequate and that no new federal regulatory activities are warranted. H7A's and the GAo's findings reflect the tremendous efforts made by state insurance regulators and the insurance industry in response to events of the late 1970s concerning agent sales. In 1577 individual state insurance
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S. HRG. 100-69 CATASTROPHIC HEALTH
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CONTENTS Opening statement by Senat
Page 5 and 6: 2 Second, I think the private insur
Page 7 and 8: 4 So the question before us is how
Page 9 and 10: 6 the elderly, long-term health car
Page 11 and 12: 8 ments for our retirement. I might
Page 13 and 14: 10 Mrs. YELINECK. Well, it would be
Page 15 and 16: 12 As I understand it, you have not
Page 17 and 18: 14 Mrs. YELINECK. One does not expe
Page 19 and 20: 16 Senator BURDICK. Well, thank you
Page 21 and 22: 18 Mrs. YEL.INECK. No. I started ou
Page 23 and 24: 20 Therefore-I am supposed to take
Page 25 and 26: 22 Chairman MELCHER. Well, I am ple
Page 27 and 28: 24 month. Let us assume it costs $1
Page 29 and 30: 26 STATEMENT BY SENATOR PETE WILSON
Page 31 and 32: 28 Mrs. RIEGER. We have; we have wo
Page 33 and 34: 30 Four years ago this August was w
Page 35 and 36: 32 she has only 50 percent vision i
Page 37 and 38: 34 Senator HEINZ. So it is both a p
Page 39 and 40: 36 rich. Indeed, in the academic co
Page 41 and 42: 38 pointedly in the comment from Mr
Page 43 and 44: 40 finding out is that it is very l
Page 45 and 46: 42 industry's role in providing cat
Page 47 and 48: 44 Senator HEINZ. So things are wor
Page 49 and 50: 46 Chairman MELCHER. In exactly the
Page 51 and 52: 48 plement policy, what should that
Page 53 and 54: 50 - 2 - I am Robert Shapland, Vice
Page 55: 52 - 4 - CATASTRIPC PROTECTION IiDE
Page 59 and 60: 56 To ensure that all of these cont
Page 61 and 62: 58 - 10 - The HJAA also endorses Me
Page 63 and 64: 60 - 12 - Finally, given that Congr
Page 65 and 66: 62 - 14 - A recent HLAA survey of o
Page 67 and 68: 64 Chairman MELCHER. Senator Heinz.
Page 69 and 70: 66 Mr. SHAPLAND. I think we are in
Page 71 and 72: 68 Those problems are real problems
Page 73 and 74: 70 Mr. SHAPLAND. Oh, no. There are
Page 75 and 76: 72 comprehension, and it is growing
Page 77 and 78: 74 that educational process, and we
Page 79 and 80: 76 So we have supported and activel
Page 81 and 82: 78 Mr. SHIAPLAND. How much would nu
Page 83 and 84: 80 rently being offered by the indu
Page 85 and 86: 82 Recently, Karri Lynn has started
Page 87 and 88: 84 Mr. Chairman and Members of the
Page 89 and 90: 86 standards for voluntary certific
Page 91 and 92: 88 non-group subscribers of reporti
Page 93 and 94: 90 We believe a new federal program
Page 95 and 96: 92 However, public awareness is nee
Page 97 and 98: 94 Item 3 Testi~ony of GAIL SHEARER
Page 99 and 100: 96 to Secretary Bowen's proposals c
Page 101 and 102: 98 -4- most-states do not monitor t
Page 103 and 104: 100 Catastrophic Protection within
Page 105 and 106: 102 - a - participants and in part
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104 - 2-- Consumers Union suV orts
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106 29), but fails to acknowledge t
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108 explore all alternatives to lon
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110 adds to the complexity of Medic
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112 - 10- Consider first the propos
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114 - 12- insurance premiums and me
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Consunmer Unon Pubtishcr of Consume
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FOR RELEASE AT 9:00 P.M. H2ST) TUES
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120 Itema I CENTER FOR MEDICARE ALw
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Page 3 122 aide services, however,
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Page 5 state treasuries." 124 Judge
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126 462 6485 New Developments 10,05
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128 462 6-85 New Developments 10,05
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130 462 6-85 New Developments 10,05
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132 10,930 New Developments tI.PZ ;
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10,932 134 New Davelopments 492 346
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136 10,934 New Developments It! ;6
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10,936 138 New Developmenlt I. Thc
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140 10,938 New Development. 492 S-8
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10,940 142 New Developments i92 586
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ATroR EYS -HARLES C. -ULiIN JUDITH
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146 reformed its decision-making pr
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148 : 14 2i57 New Developments 13,1
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~ 150 a>, rsn Cdw ~w (e d rum 0A7,.
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152 All Of these figures are based
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154 The requirements of this Act sh
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156 Drefting Note: Where the word "
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158 (b) The issuance of the group p
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160 (2) Contain a provision establi
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162 and competitive reasons. It is
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164 -13- E. Affordability of Long T
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NAIC LTC ADVISORY COMMITEE EXPOSURE
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Setinzn IS. Poicyx D~efinitieno aid
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170 3. The term "noncancellable' ma
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172 extension of benefits beyond th
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artinM B Requirmnts for Rplnmacwt 1
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176 The above "Notice to Applicant"
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(pinnal Rasting &mdsninn 178 Benefi
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APPEMI!X B 180 OCWARISCN OF lVLCY i
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COMPAIeSON OF LOtG TEIM CoAt PfLtCI
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COMPABI:SZN OF LC#C TE" CAiE -OLICI
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COWaPAISON Of LOSt TERM CARE POLICI
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cowRiiSOi or touTE reM CasE nOuczcS
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COGPARISON OF LONG TERM CARE POLICI
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SOME BASIC THINGS YOU SHOULD KNOW M
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Private health insurance is availab
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WHAT MEDICARE PART B PAYS 196 MEDIC
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EXPENSES NOT COVERED BY MEDICARE Me
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HEARING - U.S. Senate Special Committee on Aging

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