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The Health Care Choice Act of 2005 (HCCA) aims to reform perceived problems in the individual market, and is touted as part of the solution to the problem of the uninsured. It purports to allow individuals who are not eligible for or cannot afford group coverage to purchase an individual policy in and from any state. If passed, the HCCA would allow health insurers to offer individual policies of insurance from any state without being required to comply with the laws of the insured's own state. Its proponents claim that it would lower the cost of individual health insurance by bypassing state laws such as those mandating benefits, and offer consumers more choice.

The HCCA has not received a lot of attention, perhaps because it was overshadowed by another bill, the Health Insurance Marketplace Modernization and Affordability Act (Enzi Bill), aimed at the small-group market. But the HCCA is worth examining because it represents a bad choice for the individual market. It does not appear that the HCCA would lower costs for most purchasers, increase meaningful choices, or reduce the overall number of uninsured. Moreover, the HCCA would permit health insurers to sell policies from the states with the fewest consumer protections, and to market and sell those policies to consumers in all other states. This would erode important consumer protections under state law and undercut the role of the states in regulating health insurance products and protecting their citizens.

Worse, the HCCA could increase the existing problem of fragmentation in the individual and broader insurance markets and divert attention away from systemic issues such as the increasingly high cost of health care, and the growing crisis of un- and underinsurance. Indeed, the HCCA can be seen as an example of the larger political approach to health care policy, one focused on individual, market-based solutions that undermine the concept of health insurance as an expression of social solidarity and collective responsibility.



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