Or, You Could Get Rid of Silly Insurance Regulations
In 1993, Washington…passed a law both guaranteeing all residents access to private health insurance, regardless of their health status, and requiring Washingtonians to purchase coverage.
The state legislature, however, repealed that last provision two years later. With the guaranteed access provisions still standing, the state saw premiums rise and enrollment drop, as residents only purchased coverage when they needed it. Health insurers fled the state and, by 1999, it was impossible to buy an individual plan in Washington — no company was selling.
“There are seven states that tried this in the mid-1990s and, in every case, it was a disaster,” said M.I.T. health care economist Jonathan Gruber, who worked on both Massachusetts’ reform law and the Affordable Care Act. “It became pretty clear that, if you want a market to work, you need a mandate.”
This is what worries me about ACA in the Supreme Court.
I’d be ok with two Supreme Court outcomes: the whole law stay, or the whole law goes.
Not that I don’t prefer one to the other, but anywhere in-between would be catastrophic.
Progressives like Gruber have probably thought to themselves that if they put this in place on a national level, the insurers will have no state to run to.
@Brian
Interestingly enough, Gruber did a lot of the basic analyses that the administration used to support the passing of ACA. Yet, when the states asked him to run their independent studies, his results were very different and much less positive.
Maybe he’s a yes-man.
He’s a smart man – he deserves this chance to get it right.
Gruber has done some really good work on health insurance in the past. He is correct that the “silly” insurance regulations (i.e. guaranteed issue; community rating, expensive mandated benefits) without the coercive individual mandate would cause the insurance industry to implode (by contrast, RAND implausibly predicted that abolishing the mandate wouldn’t matter that much).
But I wonder if Gruber knew what he was getting into when he signed on to be the pitchman for the PPACA? He may support the goals of the PPACA; but he undoubtedly knows the regulations are unworkable (and unaffordable) in their present form.
Why is the PPACA the only piece of legislation in Washington that didn’t get a clever acronym?
This is an example of piecemeal development of regulation, as opposed to concerted thinking and thorough and comprehensive evaluation: parts don’t hold together in the end.