Why Do People Think Selling Insurance Over State Lines is A Good Idea? (wages, healthcare)
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With California Care it's restricted by Region/County. Can't go to that Dr. or Hospital half a mile away because it's in another county. Can't visit you physician that works near you job, sorry. It's ridiculous beyond measure. I'd like to see it fully open so companies can offer things the State/Feds currently don't allowed to be offered. Not everyone needs the same exact coverage but that's what we have now and the only "choice" is no choice at all. The government at any level should not be telling people what they have to purchase to cover themselves, everyone has their own way of handling things. But this is the only way to redistribute wealth, and that's what ACA is actually about.
What is "California Care"? I can't find a plan named that. I know that in most parts of California there are several different ACA plans available, maybe look for one with a better network?
The advantages of interstate health insurance far outweigh the disadvantages. There are too many states with no competition among insurance companies. If people could shop for insurance nationwide, there would be plenty of competition, and rates would go down.
Not true.
Rates will only go down if the reason insurance rates are high is lack of competition by insurance companies. That is not the case. Insurance rates are high because Americans consume a huge amount of healthcare services and the primary way to pay for that is by spreading the cost around to everyone through either private insurance or government programs like Medicare. In either case we all end up paying for all that healthcare - with higher premiums (for private insurance) or high taxes (for government programs).
Insurance companies are not the reason healthcare is so expensive. They are limited by almost all states in how much they can add to medical payments. It is typically a few percent. Insurance companies are not good guys at all, they have discriminated against people, but they are not the primary cause of the spiraling cost of healthcare.
If you really want to lower the cost of your insurance premiums, look first to lowering cost of all those services and products we all use, and then second, don't use so many of those services and products. Demand by the consumer - that would be you and me - has jacked up the price on everything related to healthcare. If demand falls, price falls. So tell your 80 year old aunt she probably does not need a knee replacement since she won't be playing tennis anyway. And tell your congressperson to legislate laws that limit price gouging and disallow single source providers to charge enormous prices for their products when they have no competition. And tell your congressperson to put limits on letting medicine be delivered through large for-profit businesses. And stop letting drug manufacturers advertise on TV which has not improved the health of people but has increased the unjustified demand for expensive drugs, which ends up increasing the price of said drug, which of course is paid by the insurance company, and that cost gets passed to all of us through higher premiums.
In the past three or so years we have seen a lot people say that Obamacare would be better if insurers were able to sell over state lines. I've always thought that the problem with that is that insurers would look to set up shop in the states with the least laws kind of a like Delaware with corporate taxation rates. I can only think of one case where I would be in favor of it (that being all but two Arizona counties only having ONE insurer) but I still think it is a bad idea. Can anyone explain this without a political bias?
Personally I think insurance should be offered at a national level because I do not reside in just one state and the fact that I have to pick the state that I buy insurance from makes my life complicated when I am not living in that state. People who move a lot are in the same situation - why should they have to change insurance just because they moved?
We ended up with Blue Cross insurance, which has a nation-wide network of doctors and has affiliates in every state. I would never buy insurance from a carrier that does not offer the same benefits in other states. After all, I could get sick while traveling, right? Why should I pay more to go to a doc in another state just because my insurance company is located in my home state?
The advantages of interstate health insurance far outweigh the disadvantages. There are too many states with no competition among insurance companies. If people could shop for insurance nationwide, there would be plenty of competition, and rates would go down. And health insurance companies should also be prohibited from discriminating by location. Whatever they charge you for a particular policy, they should charge you that same amount no matter where you live.
I'm not convinced that allowing insurers to sell nationwide without being licensed in the states they sell in would cut insurance rates. What seems to impact rates is the way that the exchange is managed, i.e. states that refuse to allow unreasonable rate hikes do better, i.e. California do better than states that don't have their own exchange. And the population of the area you live in, areas with rural populations and few doctors end up with higher rates because insurers don't have the negotiating power that they do in areas with large numbers of doctors and hospitals.
Almost everyone has something that can be called a 'pre-existing condition' if insurance companies want to get picky. Life itself is a pre-existing condition.
That said, insurance for those with pre-existing conditions should be spread out (the pool made much larger) so it is ultimately paid for by more people to keep it somewhat affordable. That means it should be removed from the standard insurance policy acquisition rules and seen as a federal issue (IF one has to keep the federal governments stinky little hands in healthcare anyway where I don't think they should be meddling at all mind you).
The ACA was designed to NOT be affordable. I read the act 3 times (amazing that I could do that isn't it .. over 3k pages by the time it was done - when no member of Congress could!) before it was slammed through (illegally in my estimation) and it is full of traps, holes, misnomers, complications, a mess of kickbacks and financial webs that are frightening, and just plain garbage that makes it so complicated and shady that I don't think it can or should be salvaged. It was written by lobbyists - not your representatives. And those lobbyists (and the politicians who support them) are there for one reason and one reason only - themselves - stuffing themselves full of our money. What are the chances they could/would produce anything that actually would have you, the average American who needs healthcare, in mind? Mind you to see that you didn't need to even read a hundred pages. The whole thing, including the website, has been a mess and a scandal and has definitely not accomplished what the supposed aim was - if you believe it has you are being lied to and are lying to yourself. And another million people will lose theirs next year as well. It is simply unsustainable. But, don't worry .. Hillary will fix it. Now about that swamp land I have for sale in Florida.
Start again. Somehow the interstate commerce clause has to be amended/some exception made for insurance, etc. I think if anyone wants to make this work at all. It is called spreading the risk by increasing the pool ... at least in terms I can understand. If you can't do that .. insurance may not be viable at all. Some say .. make it single payer but I am not so sure that is the answer in the US with insurance companies so entrenched and so many people/institutions, etc. to consider. The transition I think would be horrific and devastating to the economy and so many individuals.
Do you expect Trump to think can fix Obamacare? Him and Hillary are the only options mind you. I'm not saying Hillary would fix it but I expect her to do better than Trump could. I don't necessarily disagree with you but I don't know what the answer exactly is. I just know opening statelines isn't a good idea...
Insurers often *can* sell across state lines, but they don't want to. The NY Times explains it:
Quote:
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The trouble is that varying or numerous state regulations aren’t the main reason insurance markets tend to be uncompetitive. Selling insurance in a new region or state takes more than just getting a license and including all the locally required benefits. It also involves setting up favorable contracts with doctors and hospitals so that customers will be able to get access to health care. Establishing those networks of health care providers can be hard for new market entrants.
“The barriers to entry are not truly regulatory, they are financial and they are network,” said Sabrina Corlette, the director of the Georgetown University Health Policy Institute.
In 2012, Ms. Corlette and co-authors completed a study of a number of states that passed laws to allow out-of-state insurance sales. Not a single out-of-state insurer had taken them up on the offer. As Ms. Corlette’s paper highlighted, there is no federal impediment to across-state-lines arrangements. The main difficulty is that most states want to regulate local products themselves. The Affordable Care Act actually has a few provisions to encourage more regional and national sales of insurance, but they have not proved popular.
Insurers have been muted in their enthusiasm for G.O.P. across-state-lines plans. Neither America’s Health Insurance Plans, the lobbying group for most private insurers, nor the Blue Cross Blue Shield Association have endorsed such a plan when it has come before Congress.
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What is "California Care"? I can't find a plan named that. I know that in most parts of California there are several different ACA plans available, maybe look for one with a better network?
My mistake. It's actually Covered California. It's the state exchange. A frustrating thing we did in CA was decide that any policy sold OFF the exchange, purchased directly from the insurance company, had to mirror the plans sold ON the exchange. In my case the local physicians group at the local hospital doesn't contract with either of the two companies with plans on the exchange. There is no option at any cost or an individual to buy a plan that provides anything but the very narrow networks created to make this reform remotely possible. And it's not really flying since rates have up quite a bit every year and many companies have gone out of business or pulled out of the state altogether.
If you work for a company and get insurance via the same insurance companies on the exchange you usually get access the larger networks. This is the biggest failure of the entire thing...making individual plans a different beast than group plans. Why not one giant group plan with everyone in it? Why not different plans at different rates for narrow networks and hmo/epo's (cheap) to full fledged ppo's (more costly) that offer people a real choice? I'll never know for sure but the word "fairness" was bandied about when it all started. Basically, if someone fully subsidized can't have it either can anyone else.
There are too many states with no competition among insurance companies.
Name one. Or do you merely mean that the individual market PPACA exchanges in some states do not currently offer enough options?
Quote:
Originally Posted by eok
If people could shop for insurance nationwide, there would be plenty of competition, and rates would go down.
LOL! Coverage is what would go down. To the minimum levels of the least demanding state. Rates would remain high. Without protections, individuals simply get chewed up in the open market. Do you just not understand how all this works?
The purpose of Obamacare was to 1) set up an entitlement mentality among certain classes and 2) to disrupt the private healthcare system that served 75% of the people well. They have succeeded.
Now, we all pretty much have lousy healthcare that is getting worse each year.
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