Pelosi Makes The Case Against Prop. 45

House Minority Leader Nancy Pelosi covered plenty of territory in her meeting with The Chronicle’s Editorial Board on Monday, but one issue made her more animated than any other: state Proposition 45’s threat to the landmark federal health care law she shepherded through Congress in 2010.

“If I wanted to kill the Affordable Care Act, I would do this,” she said, slapping a copy of the initiative on the table for emphasis.

Pelosi’s expression of opposition to Prop. 45 was noteworthy in both its vehemence and its level of detail of its “potential to be very disruptive” to Covered California. It also was significant because Pelosi emphasized that she agreed with the basic concept of the initiative: to give the state insurance commissioner the authority to review health insurance premiums.

“But you have to do it the right way,” Pelosi said.

The fundamental flaw in Prop. 45 is that it allows outside “intervenors” — such as Consumer Watchdog, a Santa Monica group — to legally challenge proposed rates. Pelosi said the state insurance commissioner would be powerless to “modify or constrain” the judicial proceedings brought by such third parties. Consumer Watchdog has collected more than $14 million in “intervenor fees” from contesting auto, home and other premiums under Prop. 103 — the initiative it advanced in 1988. It built a similar bounty reward into Prop. 45.

Those health-premium review processes could drag on well past the deadlines for plans to be offered during the annual enrollment period, Pelosi explained. As a result, Californians could find themselves with fewer options — or even the inability to renew their preferred plan — because of extended rate challenges that would be beyond the control of the state commissioner.

“The ballot measure does not complement the ACA in California,” Pelosi said, “and we’re concerned that it could undermine it.”

Pelosi noted that the Affordable Care Act has given the Legislature the ability to set up a rate-review system that “works hand in hand” with Covered California and its timelines. She acknowledged that the idea of rate review “sounds so good,” but this scheme could work against its intended purpose.

“ACA is who I am,” Pelosi said. “It’s why I stay in Congress, to protect it.”

As we stated in our Sept. 15 editorial opposing Prop. 45: Don’t vote the concept, vote on the letter of the proposed law. And don’t get in the way of something that is working.

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