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Total Number of

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AntiNatvorking Provisions

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State

Alaska

Alabama

Arizona California Colorado Connecticut

Delaware

Florida

Georgia
Hawaii

Iowa

Idaho

Illinois

Kansas

Kentucky
Louisiana

Maine

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

N. Carolina

Nebraska

New Hampshire
New Jersey

New York

onio Oklahoma Pennsylvania Rhode Island

S. Carolina

S. Dakota

Tennessee

Utah

Virginia
Washington
Wisconsin
W. Virginia
Wyoming
40 STATUS

126 BILLS

32 STATZ8

25 STATES

7 STATUS

14 STATES

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Florida Georgia

Iova

Kontucky
Masyland
Mississippi
South Carolina
Virginia
Wisconsin
Wyoming

11 STATUS

14 JILLI

4 STATES

7 STATES

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Novada

New York · onio

Oklahoma

Oregon
Pennsylvanta
Rhode Island:

S. Carolina

Tennessee

Texas

Utah

Vermont

Virginia
Washington
Wisconsin
W. Virginia
Wyoming

47 STATES

202 DILLO

36 STATUS

34 STAT28

14 STAT28

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20 STATES

Otsor

26 BILL:

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11 STATL8

1 STATZ

3 STATZ8

Chairman STARK. Thank you, very much, Mr. Secretary. We appreciate your coming forward to enlighten us. We look forward to working with you as we work through this process over the next several months.

Our next witnesses are a panel consisting of the American Academy of Actuaries, represented by Nancy Nelson, Committee on Health, accompanied by Gary Hendricks, director of government information and chief economist, and probably some huge supercomputer which they have in their briefcases. Allen Feezor, chief deputy commissioner of the North Carolina Department of Insurance; and the Families USA, represented by Judy Waxman, director of government affairs.

All of the witnesses' prepared statements, without objection, will be made part of the record, and we would ask you to summarize or expand on your prepared testimony. Ms. Nelson or Mr. Hendricks, whomever you choose, please proceed. STATEMENT OF NANCY NELSON, COMMITTEE ON HEALTH,

AMERICAN ACADEMY OF ACTUARIES, ACCOMPANIED BY GARY HENDRICKS, DIRECTOR OF GOVERNMENT INFORMATION AND CHIEF ECONOMIST

Ms. NELSON. Good morning, Mr. Stark and members of the subcommittee. I am here today as a representative of the American Academy of Actuaries, Committee on Health.

As you mentioned, the Committee on Health has prepared written testimony discussing the provisions of H.R. 3626 and H.R. 2121, and I would like to ask that it be added to the record. I would also like to note the academy has previously provided written testimony on H.R. 1565.

My remarks today relate to H.R. 3626 and its potential effect on the health insurance market for small employers. Currently, there are three problems in the small group health insurance market; these include the availability of coverage, the high cost of coverage, and the predictability of rate increases. In the opinion of the Committee on Health, H.R. 3626 will address the problem of availability of coverage through its guaranteed access provisions. These include guaranteed eligibility, guarantee of issue, guaranteed renewal, and restrictions on the use of preexisting condition limitations.

As a result of these provisions, employer groups who currently have difficulty finding insurance coverage will be able to purchase coverage. Groups that now have access to coverage will continue to have access. Unfortunately, the high cost of insurance coverage will continue to be a concern, and H.R. 3626 will contribute to this concern.

This is true for three reasons. First, guaranteed issue will mean that more high-cost individuals will enter the insured risk pool, increasing average costs. Second, the rating bands will raise rates for lower cost groups causing some of them to drop coverage. Third, the core benefit package specified by H.R. 3626 is generous relative to the benefits currently provided or purchased by many small employers.

To understand why costs will increase, it is necessary to understand that there will be both winners and losers under H.R. 3626.

56-755 O - 92 - 6

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