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Lawmakers Face Decisions on Health Care Reform

By Beacon Staff

HELENA – The Montana insurance commissioner told lawmakers Tuesday the state must review health insurance rate increases or the federal government will step in and do it as part of the national health insurance law.

The warning set up what was expected to be an ongoing argument over who should be running aspects of the new law.

The rate review proposal was one of several from the insurance regulator aimed at keeping state control over implementation of regulation and oversight under the federal law.

The proposals are likely to run into problems with many Republicans who are strongly opposed to the federal program that states are expected to implement.

There will likely be conflict within the Republican caucus on the issues as well.

The insurance industry and chamber of commerce both support the plan from State Auditor Monica Lindeen to adopt state management. The business interests said it would be much better to deal with regulation from the state rather than federal government.

Supporters said the review of rates will help make sure consumers are not overcharged, and is something most all states already do. The measure will also include language that undoes the state law should the federal health care overhaul law be repealed or deemed unconstitutional.

“We want to retain state control over this process,” said Jesse Laslovich, a former lawmaker who now works for Lindeen. “Failure to do anything means insurance companies will submit rates to the federal government, despite what this Legislature does.”

The industry said it decided to endorse the bill after costs were decreased and a provision giving the auditor the right to reject proposed increases was taken out.

“We think it would be a good thing for Montana consumers,” said Frank Cote of Blue Cross and Blue Shield of Montana. “We think it is an approach that won’t cost the state or the insurance companies much money.”

Republicans who control the House by a 68-32 margin largely remained skeptical. They are advancing a platform this session looking for ways to oppose the federal health care law — not implement it.

Rep. Cary Smith, R-Billings, said the threat of federal review of insurance rates is not enough to convince him to support state implementation of the regulation.

“There are an awful lot of us that are absolutely opposed to it,” said Smith, a Billings Republican.

State Republican legislators are fighting or attempting to undermine the federal health care law in several ways. One proposal would direct the state attorney general to join about other states suing the federal government over the health care plan.

Another proposal would prevent Montanans from being sanctioned for refusing to participate in the federal health care law, which Republicans feel is too costly.

Lindeen’s office will have four proposals to implement aspects of the federal law.

One changes the appeal process for consumers denied claims, another lets the state make sure insurance companies are indeed providing consumers benefits under the law such as a prohibition on lifetime limits, and another lets the state implement the exchange for private health insurance instead of the federal government.