To The Daily Sun,
As the folks in Washington drive to eliminate the current Affordable Care Act there are many “facts” floating around that need substance to be called “facts,” but lack explanation of their effects if they were to be implemented.
Removing nonsensical analogies like covering pre-existing conditions is akin to having the person in back of you pay for your groceries, there are seemingly (on the surface anyway) logical sounding solutions that many claim would solve the problem. Rather than rant by throwing a dozen “opinions” against the wall, resulting in nothing more than fecal wall covering, I want to address just one, a decade old talking point claiming that the ability to sell insurance “across state lines” would solve the problem. While it sounds like it would foster competition and drive down costs, it does not take too much work to untangle this concept and see why it does not contribute to solving the problem.
States already have the right to allow “sales across state lines,” and have for years, the ACA has a provision in section 1333 regarding “health care choice compacts”. States can allow the sale of policies from any other state or choose to allow insurers from neighboring states. States also have the ability to determine which regulatory functions they control. The well beaten pseudo-argument of “states' rights” is well supported when it comes to health insurance policies.
So, if it is touted as the panacea to solve the insurance problem, why is there still a problem?
Turns out that regulations aren’t the main reason insurance tends to be uncompetitive. Selling insurance is a lot more complicated than just hanging out a shingle. It involves setting up complicated contracts with doctors and hospitals so customers will have access to their insured care. Then they have to attract enough customers to create a profitable risk pool. Establishing those networks of health care providers can be hard to impossible and expensive, even for current in-state providers, let alone for new market entrants. Furthermore local doctors’ offices and health care providers see new overhead costs with the addition of more insurance companies. Hence the basic rational for supplier contracts, in-network providers, primary care physicians etc.
In 2012, the Georgetown University Health Policy Institute completed a study of a number of states that passed individual laws specifically allowing out-of-state insurance sales. Despite offers to all the major providers, not a single out-of-state insurer choose to participate. Most states, including N.H., want to regulate local products themselves, and they should. N.H. has the second oldest population in the country, Utah has the youngest, and the needs of each state are very different. An insurance policy that meets the requirements of Utah simply would not meet the needs of N.H.
The Affordable Care Act actually has a few provisions to encourage more regional and national sales of insurance, but insurance companies have stayed clear. Notably, neither the insurance lobbying groups, nor the Blue Cross Blue Shield Association have endorsed any such plans when they have come before Congress.
So the concept is not a solution looking for a problem, it’s a slogan without merit, a further impediment to providing a real American national health care solution. Let’s support candidates who actually offer vetted solutions and stay away from those armed with only talking points.
- Written by Edward Engler
- Category: Letters
- Hits: 542