Why There is No Easy “Fix” For ObamaCare
This is Timothy Jost at Health Affairs:
A ste
ady stream of bills were introduced in Congress over the week as members came up with their own fixes. Congressman Upton’s “Keep Your Health Plan Act of 2013” would allow insurers throughout 2014 to continue to offer outside of the exchanges any policy that they had offered in 2013 without complying with ACA requirements that go into effect in 2014, such as the ban on pre-existing condition clauses, the essential health benefits, or actuarial value tiering. Senator Landrieu’s “Keeping the Affordable Care Act Promise Act” would go further, allowing individuals who had coverage in the nongroup market in 2013 to keep that coverage indefinitely and prohibiting insurers from terminating it unless the insurer left the market altogether. Other proposed legislation would delay the individual responsibility requirement for a year…
In any event, the proposed solutions may simply make matters worse. Allowing insurers to offer or to continue 2013 coverage into 2014 (or worse, indefinitely) will simply segment the risk pool, making 2014 coverage even less affordable to those who have been excluded from coverage or would be excluded under 2013 underwriting rules. Of course, many insurers have already extended 2013 policies into 2014, increasing 2014 premiums, but the Upton and Landrieu legislation would simply make matters worse. Moreover, insurers have already set their 2014 rates. If they were allowed (or required) to continue 2013 coverage, they would have to recalculate their 2014 rates, and then have these rates approved by state insurance departments. This is not a simple matter and would greatly add to the cost of exchange coverage and federal subsidies…
Allowing insurers to continue to underwrite based on health status for 2014 could bring down premiums for some, but would turn the exchanges into high risk pools, dramatically driving up 2015 rates and possibly causing insolvencies among the CO-OP plans and other 2014 new entrants. Even delaying the enforcement of the individual responsibility requirement beyond March 31 (which is already a month and a half delay) or open enrollment beyond that date would have serious consequences for the risk pool and insurers.
I would be willing to bet that originally one of these two plans was intended on being apart of the ACA, but after the negative effects were discovered, Obama had to go against his word of “if you like your plan, you can keep it.”
Would allowing either one of these plans help us in the long run? I personally do not see the ACA sticking around for very long after Obama is out of office. I would tend to think that allowing the insurers to continue offering existing plans would be beneficial in the long run.
Therein lies the problem when you pass a law without really knowing what’s in it. Now that this is the “law of the land”, finding ways around it are like going through a maze blindfolded.
Although, it appears Obama can make changes at his whim, so maybe it really doesn’t matter.
“In any event, the proposed solutions may simply make matters worse.”
Either way, a ‘death-spiral’ is inevitable. It’s just a matter of when.
Let’s just hope the health industry can survive these volatile times. As a taxpayer, I’m tired of bailouts.
As am I. This debt that is accumulating is just getting ridiculous.
I hope the “iGeneration” has some good ideas regarding the repayment of the debt..
“Millions of Americans with incomes below the poverty level in these states [not expanding Medicaid] are not simply facing increased premiums, but being denied coverage altogether.” (Jost)
I didn’t know this could happen?
So mental health coverage is now mandatory. Yet, “CMS estimates that implementation of the MHPAEA will expand health care costs only by 0.6 percent.” (Jost)
This cannot be accurate.
The data to calculate that number of .6% must have been based on a bad sample..
By the time anyone’s waded through all this they will need mental health coverage.
That’s why there is no easy solution; just misguided, naïve PPACA architects.
What’s wrong with turning the Exchanges into high risk pools? Sounds like a good idea to me.