Health insurance companies and state regulators are considering new rules that would require them to spend a higher percentage of their premiums on preventive care and preventative care for people with pre-existing conditions.
The changes are a step in the right direction, said Michael B. Thomas, an associate professor of public policy at George Washington University and an expert on health care policy.
He also sees the new rules as an example of why health insurance companies have been so cautious about going too far.
If insurers can spend more, then they should be able to do more,” Thomas said.
Health care is a huge business for companies and for consumers.
The federal government subsidizes premiums and deductibles for health insurance, but it is still a relatively small part of the overall health care bill.
The average health care premium for a family of four in 2017 was $2,085, according to the Kaiser Family Foundation.
The new rules would require insurers to spend 10 percent of their premium on preventive and preventive care, as well as 5 percent on the prevention and wellness program and 1 percent on wellness.
Under the rules, insurance companies would have to spend at least 2 percent of premiums on wellness and 1.5 percent on preventive, according the proposal from the National Association of Insurance Commissioners.
The proposed rules would be in effect for six months after they are released and would be phased in over a period of six years, starting in 2019.
The proposals were unveiled Friday in a draft that has not yet been formally circulated.
Insurers are also reviewing whether they can sell plans that cover less preventive care in an effort to lower the number of people with serious health conditions, such as cancer and diabetes.
Maine HealthCare, the state’s largest insurer, said it would start requiring its plans to cover more wellness services and to spend the greater part of their spending on preventive services.
A separate proposal, from the state Department of Health and Human Services, would increase the tax credits for people who buy health insurance through the marketplace to help pay for preventive services, which would help people pay more for their insurance.
States that have taken steps to encourage health insurance coverage by mandating that people buy health coverage also are proposing changes to their insurance markets.
In Pennsylvania, for example, the State House of Representatives has approved a bill that would establish a new state program to help consumers get coverage, including the health insurance that is offered by the federal government.
In Utah, state lawmakers are considering a bill to allow people to buy health plans in the marketplace with a deductible that is set at 10 percent rather than the 10 percent under current law.
California is considering a similar bill that requires that the cost of preventive care be included in the premiums of individuals buying health insurance.
The plan, if passed, would apply to the state exchanges, but would be available to everyone who buys coverage through the exchanges.
The changes are also expected to improve competition among health insurance plans, as insurers are increasingly looking for cheaper ways to cover a range of health care services.
In states with health insurance marketplaces, insurers are often reluctant to participate because they want to maximize the number and quality of coverage they can offer, said Robert L. Lehr, an analyst at the Kaiser Health News think tank.
But if insurers are forced to spend more on preventive health care, that will likely be more important for them, he said.
The Associated Press contributed to this report.