Prop. 45 fuels health rate debate

Prop. 45 fuels health rate debate PROP. 45 AT A GLANCE

WHAT IT DOES: Requires the California insurance commissioner to approve rates for certain types of health insurance, specifically individual and small group health plans. The rate-approval process would be similar to a process that is currently used for other types of insurance, such as automobile and homeowner's policies.

WHO SUPPORTS IT: Insurance Commissioner Dave Jones and Consumer Watchdog, a Santa Monica-based group founded attorney Harvey Rosenfield; California Democratic Party.

WHO OPPOSES IT: A coalition of doctors, hospitals and labor groups, with major funding from health plans that include the Kaiser Foundation Health Plan Inc., Wellpoint Inc. and Blue Shield of California; California Medical Association; California Hospital Association; California Chamber of Commerce; California Professional Firefighters; California Republican Party.

CAMPAIGN SPENDING: The groups supporting the rate regulation have raised at least $2 million through Sept. 22, while the groups opposing it have raised at least $37 million through the same period.

NAME: Dave Jones

AGE: 52. Born in Philadelphia, Pa., Jan. 4, 1962

PARTY: Democrat

EXPERIENCE: First elected in 2010, Jones leads the California Department of Insurance, regulating the insurance industry. He served in the state Assembly from 2004 through 2010, where he chaired the Assembly Health Committee, the Assembly Judiciary Committee and the Budget Subcommittee on Health and Human Services. Jones began his career as a legal aid attorney with Legal Services of Northern California, working there from 1988 to 1995.

FAMILY: Wife Kim Flores, one son, one daughter.

WEBSITE: http://ift.tt/1lWTi9b

PRIORITIES: Implement federal health care reform. Signed emergency regulation requiring health insurers to spend at least 80 cents of every premium dollar on health care, rather than on administrative costs or to improve profits. Saving policyholders money by preventing excessive rates for auto, homeowners and other property and casualty insurance.

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NAME: Ted Gaines

AGE: 56. Born in Roseville, Calif., April 25, 1958

PARTY: Republican

EXPERIENCE: Elected to the state Senate in 2010. Serves as chairman of the Senate Republican Caucus and vice chairman of the Senate Insurance Committee. Previously served in the Assembly, where he was a member of the Assembly Rules Committee. Began public service as a member of the Roseville Planning Commission from 1997 to 1999. Elected to the Placer County Board of Supervisors in 2000 and 2004. Independent insurance agent.

FAMILY: Wife state Assemblywoman Beth Gaines, six children.

WEBSITE: www.tedgaines.com

PRIORITIES: Seek to encourage marketplace competition and growth at low rates while making it easier for companies to hire and retain workers. Increase criminal penalties for fraud and clamp down on frivolous lawsuits by ending cozy relationship that trial lawyers enjoy with the department. Review department spending.

SACRAMENTO - Proposition 45 offers a simple choice for voters: Do they want the state insurance commissioner to regulate health care rates for small businesses and individual health plans?

The campaign fight over whether that would be beneficial for consumers is much more complicated.

Initiative proponents, led by Democratic Insurance Commissioner Dave Jones and Consumer Watchdog, a Santa Monica-based consumer group with backing from attorneys, say the initiative would add transparency to the rate-setting process and force health insurance companies to justify their decisions.

Opponents, including a coalition of hospitals, doctors and firefighters with major funding from health plans, say it would have a detrimental effect on California's ability to deliver lower-cost health coverage under the Affordable Care Act. They say it's a flawed initiative that would give too much power to the insurance commissioner.

The online marketplace known as Covered California launched in October 2013 as part of the state's implementation of the federal health care reforms. The exchange, which is responsible for directing Californians to an appropriate health plan, offers private coverage to those with no access to health care on the job and provides premium subsidies to most.

While the board of California's new health insurance exchange declined to take a formal position, Covered California staff did release a report critical of Proposition 45.

It found the initiative, if passed, could disrupt the exchange's work negotiating with health insurance companies, cause delays by allowing third-party challenges and risk having insurers leave the market.

Some 1.4 million people signed up for individual health insurance coverage through Covered California during its first year of operation. In July, the exchange announced that premiums for those consumers will rise by an average of 4.2 percent in 2015, about half the increase the industry has seen in the past three years.

Proposition 45 supporters say the initiative will not disrupt the new marketplace or cause delays for consumers. Instead, they say it would bring protections to the roughly 6 million Californians who buy health insurance through individual and small group markets.

While state regulators would still review health insurance rates, passage of Proposition 45 means the insurance commissioner would have the sole authority to approve or deny them.

Both sides are trying to make their case by asking voters to follow the money.

Opponents say the initiative benefits trial attorneys who collect fees for intervening on behalf of consumers.

Backers of Proposition 45 say they will be outspent by major health insurers. As of mid-September, most of the more than $37 million in opposition funding has come from four major health plans, Kaiser, Anthem, Blue Shield and Health Net.

Jones, an attorney who is running for re-election, said just because he believes health care can be improved does not mean he opposes the Affordable Care Act.

'I think that some people on the left feel so beleaguered by the opponents on the right that they're critical of things like Proposition 45 because it suggests there needs to be something done to improve the Affordable Care Act. And I think that's a sad state of affairs,' Jones said.

He is being challenged by Republican Sen. Ted Gaines of Roseville, who opposes Proposition 45.

An insurance agent, Gaines said he believes Jones has not done enough to increase competition and would like to review the department's budget, which he claims has increased since Jones took office.