The state may have to step in and set health insurance rates if insurers are unable to create cheaper plans on their own to comply with Massachusetts' historic bid to expand coverage, a leading legislator warned on Wednesday.

"They need to get the message that they need to help us make this new law work," Sen. Richard Moore, D-Uxbridge, told the Boston Business Journal.

"If they are able to be helpful, I don't see the need to go further," said Moore, who is Senate chair of the Joint Committee on Health Care Financing and one of the main architects of last year's health care reform law. "But if they want us to be able to fight off that kind of maneuver, they have to be more responsive to what the need is and come up with prices that are more realistic."

Moore first suggested legislative action on the setting of prices for health insurance plans during a Boston Bar Association-sponsored health care panel discussion on Tuesday.

He said on Wednesday he hasn't taken a position yet as to whether he supports state regulation to set rates. But he said the regulation may be an option if the market can't come up with affordable products. Such regulation would be similar to how the state sets annual auto insurance rates.

Moore said his comments are a warning to insurers that some legislators and health care advocates will push for the regulation if the revised rates aren't affordable enough.

The senator's statements come after the Commonwealth Health Insurance Connector Authority asked insurers to revise their proposals for products required as part of the new health care law. Initial proposals filed earlier this month by health insurers in the state carried an average cost of $380 per month for individuals who make above 300 percent of the federal poverty level.

The Connector Authority required the proposed plans cover at least a few doctor's visits not subjected to a deductible, and insurers say that state laws mandating insurance coverage of a variety of medical procedures will make it harder to come up with an affordable products.

Moore told the Boston Business Journal he envisions an "affordable" health plan having a monthly premium of between $250 and $280.

Insurers' revised filings are due to be submitted to the Connector Authority on Friday, Feb. 2.

_______________________________________________________________

Mark Hollmer

Boston Business Journal

All contents of this site © American City Business Journals Inc. All rights reserved.