In November, Californians will have the opportunity to vote on a potential major change in the process of approving health insurance rates.

Proposition 45 moves small group and individual health insurance into the regulatory realm of automobile and homeowner’s insurance while adding regulations for the latter two. If passed, Proposition 45 would require the approval of the insurance commissioner before health insurance companies can change their rates or other benefits for small group and individual health insurance.

Prop 45 also prohibits the use of an individual’s credit history or absence of prior insurance coverage for determining rates or eligibility for health, automobile, and homeowner’s insurance. Under the Affordable Care Act, these stipulations are already in effect for health insurance.

Prop. 45 would bring automobile and homeowner’s insurance under the same scope of consumer protection — blocking auto/homeowner’s insurance companies from using an individual’s credit history or absence of prior coverage in determining rates.

So what does this mean for voters? Californians have the opportunity to vote on how health insurance rates will be decided: Either through the current status quo of review without the authority to approve, or to give the sole authority of approving rates to one person — the insurance commissioner. It remains to be seen how much leverage Covered California will be able to exercise in negotiating rates with insurance companies.

Either way, Californians are likely to feel an impact — especially those who have small group or individual coverage.

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