Rate Regulation Initiative Proposition 45

1. Rate Regulation InitiativeProposition 45 CAHU No on Prop 45 Grassroots Campaign: Agents of Action

2. Agenda • What is Proposition 45 • Why Proposition 45 Must Be Defeated • What You Can Do

3. Agenda • What is Proposition 45 • Why Proposition 45 Must Be Defeated • What You Can Do

4. Proposition 45 • Insurance Rate Public Justification & Accountability Act • Failed to move forward as a bill • Qualified for November 4th Ballot Initiative

5. Proposition 45 Core Claim • Giving California Insurance Commissioner the power to dictate rates and benefits for all Individual and Small Group health plans will lower rates

6. Agenda • What is Proposition 45 • Why Proposition 45 Must Be Defeated • What You Can Do

7. Too Much Power for One Politician • One elected politician will approve or disapprove rates, benefits, co-pays, deductibles and treatments • Expands Insurance Commissioner’s power to include plans regulated by the Department of Managed Care • All elected Insurance Commissioners have run for Governor, except the indicted and the current ones

8. Poorly Written • Retroactive to November 6, 2012 • Insurance Commissioner could rollback 2013 and 2014 rates and require commission paybacks

9. Too Broad • Proposition 45 claims to address only premiums and benefits, reality is everything about health plans is covered • Networks sufficiency • Network discounts • Underwriting relativities • Cost sharing • Broker compensation

10. Fails to Address Cost Drivers • The cost of medical treatment • Increasing prescriptions costs • The cost of new technologies • Changing demographics • Preventable chronic conditions

11. Unnecessary • Affordable Care Act already addresses premiums through the MLR requirements • Refunds have been made

12. Is Too Expensive • The Legislative Analyst estimates administrative costs to be in the tens of millions of dollars per year • Funded with fees charged to insurers that will be passed on to consumers

13. Unintended consequences • Carriers may reduce product offerings or leave the market altogether • Commissioner’s decisions could interfere with physician treatment decisions

14. Encourages Chaos • Interveners can earn $675 per hour for objecting to filings • Interventions would delay product introductions and rate changes • Under Proposition 103, average rate filing subject to intervention takes 343 days • Last minute challenges to Covered California’s plan designs and rates would disrupt the Exchange

15. Covered California Concerns Prop. 45 sparks turf war over health insurance regulation in California Ventura County Star Prop 45 Threatens California’s Health Reform Success Story San Jose Mercury California health exchange weighs formal opposition to Proposition 45 The Sacramento Bee

16. Fails to Benefit Consumers But does benefit: • Politicians • Trial lawyers (the funders) • Interveners

17. Agenda • What is Proposition 45 • Why Must Proposition 45 Be Defeated • What You Can Do

18. Join the NO on Prop 45 Coalition • ACA proponents • Physicians and Nurses • Hospitals • Unions • Building and construction trades • Business groups • Democratic and Republican Legislators • Health plans and brokers

19. Groups Opposed (Partial List) • California Chamber of Commerce • Small Business Majority • California Hispanic Chamber • California Black Chamber of Commerce • California Asian Pacific Chamber of Commerce • Service Employee International Union California • State Building and Construction Trades Council of California

20. Groups Opposed (Partial List) • California Medical Association • American Nurses Association California • California Hospital Association • California Children’s Hospital Association • William Jefferson Clinton Democrats • California State Conference NAACP • William Jefferson Clinton Democrats • CAHU and NAIFA

21. You Can Make the Difference The 40 Vote CAHU Challenge 10 NO Votes from CLIENTS 10 NO Votes from CLIENTS’ EMPLOYEES 10 NO Votes from FAMILY & FRIENDS 10 NO Votes from EMPLOYEES/COLLEAGUES 40 NO VOTES x 2,500 CAHU Members = 100,000 NO VOTES

22. Tools You Can Use The Agents of Action Web Site

23. Tools You Can Use Materials to educate and motivate your clients, colleagues, family and friends: • Emails • Letters and Postcards • Flyers and Brochures • LinkedIn posts • Campaign giveaways (posters, pens, buttons)

24. What We Must Do • Vote NO on Prop 45 • Educate and motivate clients, colleagues, friends and family • Recruit local businesses and civic groups • Get out the vote: No on 45!

25. Additional Resources • www.AgentsofAction.org • www.NoOn45.org

26. Questions? • CAHUInfo@gmail.com • Jennifer Zins • jennifer@perrycom.com • (916) 871-0603 Paid for by No on 45: California Association of Health Underwriters Issues Committee for Responsible Health Insurance Regulation, with major funding by California Association of Health Underwriters, LISI, Inc., National Association of Health Underwriters, Warner Pacific Insurance Services, and Word & Brown Insurance Administrators, Inc.