NAIC health panel to study ‘affordability,’ other disparities in 2026

State health insurance regulators agreed Thursday to beef up their 2026 charges to include a bigger focus on disparities in health insurance.

The Health Insurance and Managed Care Committee amended its task list for next year to include tackling “consumer affordability and coverage continuity,” as Chairman Glen Mulready phrased it. Mulready is the Oklahoma insurance commissioner.

The change satisfied a group of 23 consumer representatives who signed a letter urging the National Association of Insurance Commissioners’ committee to add this sentence: Examine factors contributing to disparities in coverage and affordability and recommend appropriate steps to reduce those disparities.

Earlier this week, the NAIC sent a letter to congressional leadership urging immediate action to extend enhanced premium tax credits under the Affordable Care Act. This marks the fifth letter the NAIC has sent to Congress since July 2024 regarding the tax credits.

'In every working group'

Amy Killelea is an assistant research professor at the Center on Health Insurance Reforms, a research center within Georgetown University's McCourt School of Public Policy.

She spoke for the letter signatories and noted that the commitment to address disparities in coverage reflects the work of the Special Committee on Race and Insurance, which the NAIC formed after the 2020 murder of George Floyd and disbanded last year.

“It should be  in every working group and task force as far as we’re concerned,” Killelea said. “We would like to see a specific commitment to disparities in every single work stream.”

Disparities in health care coverage persist across various populations in the United States, primarily driven by income levels, race/ethnicity, and geographic location. Key factors include the potential expiration of enhanced Affordable Care Act subsidies, state-level Medicaid expansion decisions, and underlying socioeconomic determinants of health.

Still, it is rare for an NAIC committee to make an immediate change to its charges, which generally change little from year to year. Committee members had a brief debate about whether the language was too specific.

“To me, those are very specific ways to get at what it is we're doing,” said Anita G. Fox, director of the Michigan Department of Insurance and Financial Services. “And I look at the charges as kind of an overarching statement of what we want to get done, necessarily how we want to get to it.”

Maryland Insurance Commissioner Marie Grant saw it differently.

“I actually thought this language … was very appropriate, because I think it gives us good ways to have flexibility to look at disparities throughout,” Grant said.

ACA health coverage drama

The committee voted to add language covering “consumer affordability and coverage continuity.” The letter and request from the consumer representatives reflected the fraught political environment associated with healthcare availability.

Congress reached a short-term deal to reopen the government earlier this month, but another shutdown threat looms in January unless Republicans and Democrats can strike a deal on ACA subsidies.

“[G]iven the specific and acute challenges facing health insurance markets and the consumers they serve – including anticipated coverage losses affecting millions of consumers across in the individual market and Medicaid – we believe [the] Committee has an opportunity to provide a venue to discuss and address these challenges,” the letter reads.

Committee members noted that its underlying task forces – the Health Actuarial Task Force, Regulatory Framework Task Force, and the Senior Issues Task Force – already adopted their 2026 charges, but that new chairs will be able to amend those charges if they wish.

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InsuranceNewsNet Senior Editor John Hilton has covered business and other beats in more than 20 years of daily journalism. John may be reached at [email protected]. Follow him on Twitter @INNJohnH.