Chances for a reinstatement of state regulation of health insurance rates this legislative session are dimming, with only a single bill out of 10 proposed measures surviving at the Legislature.

Even at that, one of the chief proponents of the rate oversight said the remaining bill has been weakened through amendments.

"Right now I'm worried because 10 proposals indicates the widespread support for this law, yet the one bill that is surviving has been significantly watered down to the point where I'm not sure it would be effective," said state Insurance Commissioner J.P. Schmidt.

The state had health insurance regulation for three years, but last year the Legislature didn't extend the law and the oversight ended on June 30.

Opponents, including the Hawaii Medical Service Association and Kaiser Permanente Hawaii, the state's largest health insurer and largest health maintenance organization, respectively, have both argued against regulation, saying it isn't needed.

HMSA testified against measures during the current session, saying the rate regulation didn't achieve goals of increasing competition or delivering benefits for consumers. Kaiser noted that health insurance premium increases have been lower in Hawai'i than the rest of the nation and the bills didn't address the root causes of escalating healthcare costs.

"We recognize the seriousness of the rising costs of healthcare, but strongly believe that health plan rate regulation has proven that it is not the answer," wrote HMSA director of government relations Jennifer Diesman in testimony submitted to the Legislature.

Schmidt, along with the Hawaii Government Employees Association, the Retail Merchants of Hawaii, and the Kokua Council, have appeared before committees requesting the re-regulation. Schmidt said the state has some responsibility to monitor pricing because the state requires employers offer healthcare insurance to employees.

Between 2003 and 2006 the oversight resulted in rejection of $18 million of proposed increases.

RESULT OF REGULATION?

Schmidt said Summerlin Life & Health Insurance Co. decided to begin offering policies in Hawai'i in part because the regulation was in place to keep large insurers from adopting rates to drive it out of the market. Schmidt said Hawai'i is one of the few states that doesn't have some sort of regulation.

"All the different groups that proposed these different bills do need to contact their legislators to make sure we get a good law passed again," he said.

Last year some of the same arguments were made as regulation proponents tried to get the law extended. But the House and Senate failed to agree on a measure and the extension failed.

Reach Greg Wiles at gwiles@honoluluadvertiser.com.