Mandated Offer or Mandated Coverage?

I just got off the phone with Dan and Morgan with the ACA, and they were incredibly helpful. First, on the mandated offer issue: they said that the issue really comes down to whether insurance companies right now are cutting coverage completely or just restricting coverage with caps. Since in Missouri they are using caps and other clauses, a mandated offer would do the trick for us. The Federal bill is actually a mandated offer, a compromise they made since it would take forever to get anything at all in some states.

Morgan recommended that we not compromise on individual policies; some are regulated on the Federal level because they are self-insured, but we should insist that any mandated offer legislation cover both group plans and all individual plans regulated at the state level. And, we should make sure that when prosthetic coverage is offered, that coverage is at the level of Medicare without caps or other restrictions. Our negotiating strategy going forward could be that we come back with this kind of proposal, rather than completely playing hardball and demanding mandated coverage. The downside is that, as Jean and Suzi pointed out last night, amputees who need to get individual coverage may still face a pre-existing condition exclusion.

I need to get them the names of key legislators we hope to move to our side of the issue. Morgan said that they can help us get some targeted press in that legislator’s district and maybe organize a meeting of our supporters in their district. This is sometimes especially difficult for rural districts, and they said they could help; so if you guys remember who might have been on-the-fence with the power to make the bill move, send me the name. Maybe Kent can help with this, too.

Any more ideas, let me know. Hope all this is helpful. And please let’s dialogue about the mandated offer/coverage issue; we may want to start out asking for coverage and then compromise later on an offer only if we have to.