Pension & Benefits News Sell health insurance across state lines? Let’s not, PIA National says
Wednesday, March 27, 2019

Sell health insurance across state lines? Let’s not, PIA National says

By Pension and Benefits Editorial Staff

Insurance sales across state lines constitute a clear threat to the successful state-based system of insurance regulation. That’s according to the National Association of Professional Insurance Agents (PIA National), which is strongly opposed to proposals that would allow the sale of health insurance across state lines.

Following President Trump’s October 2017 executive order (E.O. 13813), directing federal agencies to consider ways to increase competition and consumer choice in health care, the Centers for Medicare and Medicare Services (CMS) issued a 60-day request for comment on selling health insurance policies across state lines.

PIA National is a steadfast supporter of the continued regulation of insurance by the states as outlined by the McCarran-Ferguson Act of 1945, and opposes all proposals that would create a version of federal insurance regulation, in full or in part. Allowing the sale of health insurance across state lines could strip the states of their authority over health insurance and undermine the regulatory structure set up by McCarran-Ferguson, according to PIA National.

“In its notice, CMS seeks to dismiss these concerns, but we don’t find their assurances credible,” said PIA National Vice President of Government Relations Jon Gentile. “The CMS says its request ‘is not intended to inform policy which will preempt state law or otherwise impede the role states play as the primary regulators of insurance,’ however, we believe that’s exactly what would happen, even if its intent might initially be benign. PIA is opposed to proposals such as this one, which would transfer regulatory authority from the states to the federal government.”

PIA National agrees that the Affordable Care Act (ACA) needs to be reformed and that the goal of controlling health care costs is a worthy one. But it says the solution for these challenges is not the dismantling of the successful state insurance regulatory system.

“State governors, legislators, and regulators know best what will work in their own unique markets,” Gentile said. “Allowing health insurance to be effectively exempt from state regulation by permitting insurers to pick their own regulator in one state—and by so doing, evade the requirements of all 49 other states—would eviscerate local control.”


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