Thursday, November 19, 2009

Risk, No Longer A Part of Insurance?


`(a) In General- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market--

`(1) such rate shall vary with respect to the particular plan or coverage involved only by--

`(A) family structure;

`(B) community rating area;

`(C) the actuarial value of the benefit;

`(D) age, except that such rate shall not vary by more than 2 to 1;

`(E) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and

`(F) adherence to or participation in a reasonably designed program of health promotion and disease prevention, if such a program is offered by the employer that is the sponsor of the coverage involved; and

`(2) such rate shall not vary with respect to the particular plan or coverage involved by health status-related factors, gender, class of business, claims experience, industry, or any other factor not described in paragraph (1), except that group health plans and health insurance issuers offering group health insurance coverage may establish premium discounts or rebates for modifying otherwise applicable copayments or deductibles in return for adherence to or participation in reasonably designed programs of health promotion or disease prevention.

`(b) Community Rating Area- Taking into account the applicable recommendations of the National Association of Insurance Commissioners, the Secretary shall by regulation establish a minimum size for community rating areas for purposes of this section, which, for areas contained in a Metropolitan Statistical Area, shall not be smaller than such area.

Wednesday, November 04, 2009

3 Elections That Dictate the Next Seven Years

A lot of attention has, for better or worse been focused on three relatively minor off year elections. The Republicans have been banking on reinfoced vigor from sparky new compains in the face of Dem calamity. To some extent they have been vindicated both in the NJ and VA races but then there's the odd results in NY 23.

I say NY 23 is bad for R's everything else is bad for D's and the lot of it is great for all of us.

To start where the choice was a clear up down vote on support for the ruling party there was a resounding GFY. That's good, even if you aren't a big fan of the R's a vote of no confidence is generally a good vote when one group is in charge. It tends to help them realize their jobs are not ordained. Then there's the bizarre set of circumstances RE ny23> I was interested in this race precisely because a candidate was challenging the R base on the grounds that they were not conservative enough. There has been a pretty big scuttlebutt around that the R's lost the white house because they didn't field a candidate who sufficiently energize their conservative (read christian) base. But now we can all be clear, more right wing is not what the party is missing. Both of the gubernatorial candidates that won this week ran not on platforms of right wing religious conservative reform but on platforms of smaller government and lower government spending. The old conservative guard is back. The Goldwater republicans won while the neo-con's signed their own demise. It's a god thing across the board. Eyes open for the next years guys but the wind is blowing and it would rather be free.