Replacing the ACA: Selling Across State Lines
A cornerstone of every Republican plan to replace the Affordable Care Act (ACA), including the president’s plan, is to allow health insurance companies to sell their products across state lines. The Republicans claim this will increase competition and drive down costs.
Health policy experts, including the National Association of Insurance Commissioners and the Center for Insurance Policy and Research, say it will do exactly the opposite: Drive up costs and reduce choice, particularly for those with medical conditions.
State Regulations on Health Insurance
First, a bit of background. States regulate all small group and individual health insurance policies through their insurance commissioner, although the federal government sets certain minimum requirements that plans must offer, like the 10 essential benefits required under the ACA.
States can mandate that their licensed insurers add certain benefits, like infertility coverage. They also determine how much older people can be charged for premiums on the individual market and how much money insurers must have available to pay claims.
Next, the Republicans make it sound like federal law prohibits selling insurance across state lines. Nope. That, … Continue Reading
I’ve been writing this blog on and off for about eight years. And in all that time, I’ve tried to keep it as apolitical as possible. But, at my core, I am a writer. It’s all I’ve ever done for 30 years. And when writers can’t make sense of the world, or don’t know what to do with their feelings, well, they write.
The serendipity of the universe never ceases to amaze me. A couple of days ago I gave the keynote speech on healthcare reform at the Texas Medical Association’s CME Association’s annual meeting in Austin. A physician in the audience brought up an issue that was trumpeted in the press when the health care exchanges rolled out for open enrollment; namely, that people had lost their insurance and couldn’t see their doctors. I knew that a very small minority of people had actually “lost” their insurance, and that, in most cases, that insurance provided pretty bad coverage at fairly high prices. But I didn’t want to get into it with him, so I just agreed that yes, the Affordable Care Act certainly has flaws, then moved on to the next question.