Insurers at the gates: Who gets the state imprimatur under the Massachusetts universal health care law?

Yesterday’s Boston Globe highlighted a potential problem with the creation of new insurance markets under the Massachusetts universal health care law.  One currently-licensed "limited benefit" insurance company, within weeks of being touted by the Insurance Commissioner at a Health Insurance Connector Authority meeting, was being sued by the Attorney General based on allegations of deceptive marketing practices and improper denial of claims.

The Insurance Commissioner says that consumers need choices, and that her agency can monitor the activities of individual insurance companies to ensure they operate according to the law.  At least one advocate says there should be high standards for insurers participating in the programs endorsed by the Connector, so as to protect the interests of consumers.

A Healthy Blog is not convinced that state monitoring is the way to go here, and asks whether high-deductible, low coverage plans put lower-income consumers at risk, and what the Connector can do to protect consumers.

As I noted in an earlier HealthBlawg post, the recently published RAND meta-analysis of consumer behavior within consumer-directed health plans and health savings accounts shows that this is indeed a valid area of concern.

In terms of screening insurers, the Connector, in the time remaining before the program goes live, can probably do little more than examine ratings of insurers offered by other organizations or agencies, and develop a composite scoring system, weighted based on the relevance of the other rankings — on measures that may range from financial stability to quality of care to consumer satisfaction to regulatory compliance in Massachusetts and beyond –to the matter at hand.

The Connector has its work cut out for it.

— David Harlow