The ACA includes a weak coverage requirement that will encourage people to wait to purchase coverage until after they are sick, which unfairly penalizes those who currently have coverage.
A wide range of leading economists and health policy experts agree that enacting guarantee issue and community rating has severe unintended consequences unless they are paired with a strong commitment to achieve universal coverage through an effective and enforceable personal coverage requirement.
Studies show that states that have imposed guarantee-issue and rating reform laws in the absence of a personal coverage requirement have seen a rise in insurance premiums, a reduction of individual insurance enrollment and no significant decrease in the number of uninsured.
Latest Documents
AHIP filed a policy-oriented amicus brief in the US Court of Appeals for the 4th Circuit that reiterates our longstanding position that the guarantee issue and community rating provisions of the Affordable Care Act (ACA) are inextricably linked to the law’s personal coverage requirement. The decision in the District Court struck down the individual mandate, but left the market reforms in place—a situation which experience in the states has demonstrated would have severe unintended consequences for consumers.
Litigation/Amicus Briefs
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03/07/11
Washington, DC - Health plans today reiterated their strong support for new market rules and consumer protections to cover all Americans and guarantee coverage for pre-existing conditions. "Health insurance reform is an essential part of health care reform", said AHIP President and CEO Karen Ignagni.
Press Releases
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Strategic Communications
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07/29/09
Washington, DC - Health plans today proposed guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate. Under the new proposal, health plans participating in the individual health insurance market would be required to offer coverage to all applicants as part of a universal participation plan in which all individuals were required to maintain health insurance.
Press Releases
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Strategic Communications
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11/19/08
A report by Milliman, Inc. examined the impact of enacting guarantee issue and community rating without covering everyone. According to the report, these initiatives have the potential to cause individuals to wait until they have health problems to buy insurance. This could cause premiums to increase for all policyholders, increasing the likelihood that lower-risk individuals leave the market, which could lead to further rate increases. If this continues, the pool or market could essentially collapse or shrink to include only the high-risk population.
Other Reports/Papers
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08/30/07