The office of insurance commissioner is pretty far down the ballot and hardly noticeable compared with all the other high profile positions vying for voter attention. But 11 states have publicly elected insurance commissioners, though the post is only on ballots this November in California, Georgia, Kansas and Oklahoma. The only thing that could make the post remotely interestingly to most people is how the candidates differ in their approach to the Affordable Care Act.
In California, the focus is on Proposition 45, which would allow the insurance commissioner to regulate health insurance rates. Currently rates are set competitively in the online marketplace known as Covered California. In addition, rates are moderated by the fact that health insurance companies are subject to the minimum medical loss ratio (MLR) provision of the Affordable Care Act, which requires carriers to spend at least 80% of premiums from individuals on medical care (85% for large groups).
Opponents of the law see too much room for political mischief in the discretion that would be allowed to the commissioner. Rates could become unprofitable and cause insurers to flee the state. Incumbent Democrat Insurance Commissioner Dave Jones favors the measure. His challenger, Republican Ted Gaines, opposes it, saying the office doesn’t need the additional power. What’s more, Gaines believes Jones has not done enough to increase competition to lower costs and has needlessly grown the department’s budget while in office. Jones is favored to win in Democratic-controlled California.
In Kansas, the news has been about the endorsement by outgoing Insurance Commissioner Sandy Prager, a Republican, of Democrat Dennis Anderson. The hot issue is Republican insurance commissioner candidate Ken Selzer’s support of the Medicare Compact that Republican Governor Sam Brownback signed with eight other states. The states in the compact want to keep control of Medicare at the state level while still accepting federal funds.
In Georgia, attitudes toward the Affordable Care Act sharply define the candidates. The Republican incumbent Insurance Commissioner Ralph Hudgens sees Obamacare as “the problem.” He would create a national “high-risk pool and let the government subsidize” people but let them “choose the benefits they want, instead of everyone having to take the benefits that the Affordable Care Act mandates.” Democrat Liz Johnson strongly supports the ACA, especially in view of the estimated 1.8 million Georgia residents without health insurance as of the beginning of 2014.
In Oklahoma, incumbent John Doak is running unopposed as the Republican candidate.
In the other 39 states, the insurance commissioner is an appointed position. In New Mexico and Virginia, a public commission makes the appointment. In the other 37 states, the governor appoints the insurance commissioner. The states with elected insurance commissioners not up for election now are Washington, Montana, North Dakota, Louisiana, Mississippi, North Carolina and Delaware.
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