In response to concerns raised by California's health exchange, backers of a statewide ballot measure on health insurance rate regulation insisted Thursday that the measure would not disrupt how Obamacare works in the state.
Consumer groups and California Insurance Commissioner Dave Jones are pushing for more authority over health premiums for consumers and small businesses. In November, voters will decide whether to give the insurance commissioner veto power over rate increases.
Officials at the Covered California exchange, which signed up 1.4 million people under the federal health law, say they won't take a position for or against the ballot measure. But the exchange has expressed a number of operational concerns if the measure passes, from delays in getting new rates approved to what happens if an insurer's premiums are rejected just before open enrollment.
There were also questions raised about whether the stricter rate review could apply to co-payments, benefits and the scope of medical networks offered by insurers.
In a report issued to the exchange's five-member board Thursday, the state agency said contracting with health plans and negotiating rates is a "tightly choreographed sequence that begins anew at the beginning of each calendar year" and "under the current timelines there is very little flexibility in the event there are major delays."
Peter Lee, the exchange's executive director, said the agency's analysis of the ballot initiative is still ongoing.
"There are a lot of questions we need to sort through," he said.
Susan Kennedy, a Covered California board member, was more pointed in her criticism of the ballot measure and its potential effect on consumers.
"I'm a little afraid we are tiptoeing around this impact that could be really huge and very negative on our ability to function," Kennedy said at the board meeting.
Robert Ross, another exchange board member, said he wanted more information on what the ballot measure could mean for policyholders. "There may be good things for consumers in here and maybe not," Ross said.
Consumer Watchdog, the Santa Monica advocacy group that put the rate regulation measure on the ballot, says the exchange's concerns are overblown.
"This rate regulation initiative is not going to slow down the work of Covered California," Jamie Court, president of Consumer Watchdog, told the board.
Janice Rocco, the state's deputy insurance commissioner, said she's confident her department can meet whatever deadlines are needed so the exchange can be ready for open enrollment. The next sign-up period starts in November.
This initiative on health rates is patterned after Proposition 103, the 1988 ballot measure that gave the insurance commissioner authority over property and casualty insurance rates and established the process for outside groups to intervene.