Members of the health insurance industry announced Wednesday that they would support an overhaul of the health care system, requiring of insurers to accept all customers of illness of disability. In return, the industry asked Congress to require all Americans to have coverage.

The insurers’ two main trade associations’ proposal can potentially put a new spin on the debate on universal health insurance with President-elect Barack Obama preparing to take office.

America’s Health Insurance Plans and the Blue Cross and Blue Shield Association, which are the two aforementioned groups, announced separately that they would support guaranteed coverage for people with pre-existing medical conditions, in conjunction with an enforceable mandate for individual coverage. If such a mandate does not exist, insurers that many people would wait until they become ill before buying insurance.

Members of Congress stated on Wednesday that they intend to pass legislation next year, according to Barack Obama’s plans to expand coverage and reduce health care costs.

The position taken by the insurance industry is a complete 180° to their stance back in 1994 when they ground Bill Clinton’s plan for universal health coverage. The turnaround may make things for the new legislation much easier.

The industry’s position is different from Mr. Obama’s in one particular aspect though: Insurers want the government to require everyone to get and maintain insurance, whereas Obama’s plan would initially only require children to do so. This is consistent with Obama’s views that the government should be certain that insurance was affordable and available before making it a requirement. The Obama transition team declined comment on the matter.

The other side of the coin is that many people with cancer, diabetes, traumatic brain injuries or other serious conditions found themselves unable to get insurance at any price.

According to research, some insurers turn down 10 percent or more of applications for individual coverage due to pre-existing medical conditions.

Donald G. Hamm Jr., president of Assurant Health, explains the industry’s reasons for asking for an individual mandate to be coupled with a ban on the underwriting practices.

“In the individual market, people can choose whether or not to apply for coverage,” Mr. Hamm said in an interview. “If they know they can obtain coverage at any time, many will wait until they get sick to apply for it. That increases the price for everyone.” Insurers have found that this has happened in individual states where laws prohibited insurers to reject applicants based on their health status.

The new policy statements don’t mention how to enforce individual mandates and regulate insurance premiums. This leads to another issue. If the government wants to make insurance universally available, it must address not only the matter of companies selling to anyone, but also the fact that many may not afford it. And regulating the rates is going to be a very thorny issue, one caught between financial interests of insurers against those of consumers.

The insurance industry thus sees the mandate as an indispensable corollary to make the system work. “Insurance works best when everyone is in the pool,” said Alissa Fox, a vice president of the Blue Cross and Blue Shield Association. “You need healthy people in the insurance pool to help pay for sicker individuals who are much more motivated to buy coverage.”