“It will do monumental things for people who get covered and can go to the doctor and get prescriptions filled and have some peace of mind that they can take…
By Cindy Zeldin and Joann Yoon
On Election Day, Georgia voters will head to the polls to elect our state’s policymakers. Most voters are familiar with certain elected offices, like that of Governor, but many Georgians may be unaware of the importance, or perhaps even the existence, of the Office of State Insurance Commissioner.
The Insurance Commissioner runs the Georgia Department of Insurance and is elected every four years in a statewide vote. Among the core functions the Department of Insurance performs is the regulation of health insurance in Georgia. The Insurance Commissioner ensures that companies selling individual and small group policies in Georgia are financially solvent and enforces consumer protections and state laws regarding benefits that private insurers must include in policies sold in Georgia.
With the recent enactment of the Affordable Care Act, the new health care law, the role of the Insurance Commissioner has expanded. Our next Insurance Commissioner’s decisions will play an important role in shaping Georgia’s health insurance system for consumers in 2011 and well into the future.
Decisions made by the Insurance Commissioner will help determine whether Georgia will seek to maintain its own regulations on health insurers or pass much of that responsibility onto the federal government. For example, Georgia recently decided not to create a state Pre-Existing Condition Insurance Plan, or high risk pool for individuals with pre-existing conditions, and instead allowed Georgia consumers to access a federal pool. When that pool expires in 2014, insurers will be prohibited from denying coverage to applicants based on pre-existing conditions or carving out those conditions from coverage, and Georgia consumers in the high risk pool will move to traditional private health insurance. The Insurance Commissioner is responsible for overseeing Georgia’s implementation of this new rule.
The Insurance Commissioner is also a member of the National Association of Insurance Commissioners, the body charged with developing a range of model rules, standards, and definitions for implementation of the new health care law. Many of these new rules and standards are currently being negotiated. For example, beginning on September 23rd of this year, insurers were forbidden from denying coverage to children with pre-existing conditions. Some insurers chose to withdraw from the child-only market, and in response the Secretary of Health and Human Services is now working with this association and individual state insurance commissioners to clarify rules in this area to ensure that all children have access to coverage.
Federal officials, insurance company executives, and the National Association of Insurance Commissioners are negotiating the essential health benefits that insurers will be required to include for plans sold within the new health insurance exchanges, or marketplaces, that must be up and running in every state by 2014. Once these rules are enacted, the Insurance Commissioner will monitor compliance by insurers and guarantee that consumers are treated fairly in any appeals process they undergo if their claims are denied. This is just a sampling of the critical roles and responsibilities of Georgia’s next Insurance Commissioner.
To educate Georgia voters on the role of the Insurance Commissioner with respect to health care issues, Georgians for a Healthy Future and Voices for Georgia’s Children surveyed the Republican, Democratic, and Libertarian candidates for Insurance Commissioner. All three candidates provided responses to eight questions about how they would approach the health insurance issues that fall under the purview of the office they are seeking. Today our organizations are releasing those responses, and we encourage you to take a look at what they have to say (download the guide here.)
Quality, affordable health coverage optimizes the health and wellbeing of Georgia’s children and families and ensures a healthy, productive workforce to grow our state’s economy. While the Insurance Commissioner alone is not responsible for the health of Georgia constituents, he or she will be one of a key group of elected and appointed state officials who together will implement different components of the new health law to maximize benefits for Georgians.
Cindy Zeldin is the Executive Director of Georgians for a Healthy Future. Joann Yoon is the Associate Policy Director for Child Health at Voices for Georgia’s Children.