House OKs limits on health insurance

April 2, 2008 12:00 am

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By a 131-72 vote, the Pennsylvania House approved legislation yesterday that would impose new guidelines on health insurance plans offered to individuals and small businesses.

The legislation, which now moves on to the Senate, would limit the ability of health insurers to consider certain factors such as health history in setting rates for those plans. Insurers could consider age and geographic region in setting rates.

The bill also would require insurers to spend 85 percent of premiums on health care. Those that did not meet the standard could be required to issue rebates to policyholders.

The bill also would allow the Insurance Department to disapprove a rate increase request, in part, because the insurer has not operated efficiently or has not controlled costs for avoidable hospital-acquired infections or management of chronic disease.

The provisions are similar to those proposed by Gov. Ed Rendell as part of Prescription for Pennsylvania, his plan to cut the cost of health care and improve access and quality.

"The governor is certainly pleased that progress is being made, and is hopeful legislators will see the urgency of working on the rest of the plan," said his spokesman, Chuck Ardo.

While some other parts of the governor's plan have been approved, Senate Republican leaders have not reacted favorably to a House Democratic proposal to extend to the uninsured health insurance that is similar to one Mr. Rendell proposed. Part of their concern is that the governor and House Democrats have linked the proposal to continuation of the MCare abatement program, which helps doctors pay their malpractice insurance premiums.

Joe Pittman, a spokesman for Sen. Don White, R-Indiana, chairman of the Banking and Insurance Committee, indicated yesterday that Republicans would have a similar reaction to the House insurance bill.

He said Mr. White would have little interest in considering legislation that, in his view, limits competition in the insurance marketplace.

In other action yesterday, the House approved legislation that would allow companies to not pay for preventable medical errors that result in death or serious disability. The provisions are similar to those in the Medicare program and the state's Medicaid program.

Joe Fahy can be reached at jfahy@post-gazette.com or 412-263-1722.
First Published April 2, 2008 12:00 am

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