Trump - Insurance

This is a disaster . This means co's and associations will be able to exploit states with weak protections and weak insurers buying business. So for instance new york state co's which have little choice as few insurers there will be able to shop in other states. This means fly by night co's will get licensed in lax states and buy business knowing they won't last. Why do you think every other industrialized nation has a medicare type system were all are insured and pay into it?Its the only way to make health insurance work. Every person in the country (wether sick or in good health) must pay into the system,. Insurance co's must excluded from health ins.I've been on both sides of health ins as self employed and having employer benefits. The truth is when you have employer benefits you want no changes as it great. When your self employed you want a medicare type system
Could you explain in English?
 
The properly licensed agent can sell "across state lines" but he cannot sell a product that is not available in that state.. They are trying to say that now you can buy a NJ product in TN if you think the premium, benefits, etc.
This is how I understand it.. even if you're not licensed in the said state, you can sell the product.. Wouldn't that be nice for med sup agents who are on the phones selling to 30 plus states - who all qualify for the same coverage. One license(for the agent) for all(prospects) who qualify for that coverage - regardless of where they reside.

One call, that's all. Sounds to easy - I must be wrong.
 
This is how I understand it.. even if you're not licensed in the said state, you can sell the product.. Wouldn't that be nice for med sup agents who are on the phones selling to 30 plus states - who all qualify for the same coverage. One license(for the agent) for all(prospects) who qualify for that coverage - regardless of where they reside.

One call, that's all. Sounds to easy - I must be wrong.
Not sure it addresses agent licensing.. Also don't think it applies to medicare supplement. Think it just involves the insured being able to buy an out of state ACA exchange plan. .
 
Would you want to buy a Kentucky Health Insurance Plan if you lived in California? There would be no network.

That would be nice if you just had a license once in your licensed for all 50 states, that would be a big huge plus. But it’s not going to change much because the companies that want to sell all 50 states now are licensed in all 50 states. It’s just a huge hassle to do it.

Your assumption that the out-of-state person buying coverage would not have a network is likely not true. In your Kentucky Health Plan example, the idea is that the plan would be utilizing a provider network in California.
 
In your Kentucky Health Plan example, the idea is that the plan would be utilizing a provider network in California.

And that California network will cause huge rate increases to that Kentucky Plan.

Plans in KY are cheaper than in CA because the Cost of Care is higher in CA.

Premiums are based on the cost of care in that state.

If everyone starts buying across state lines to find cheaper coverage, eventually, everyone will pay the same rates. Its just a matter of simple logic and simple math.
 
And that California network will cause huge rate increases to that Kentucky Plan.

Plans in KY are cheaper than in CA because the Cost of Care is higher in CA.

Premiums are based on the cost of care in that state.

If everyone starts buying across state lines to find cheaper coverage, eventually, everyone will pay the same rates. Its just a matter of simple logic and simple math.

Not necessarily true. Premium costs would be developed by region or geography, as they are now. The idea of an association plan and selling across state lines is very similar to a self-funded plan with employees in multiple states. The self-funded association plan has the ability to start with a much lower cost, due to savings in state premium taxes, less benefits, better cost incentives, better ability to attract lower risk, etc. This gives it a significant advantage over fully-insured competitors.

A great example of this can be found in the old CalChoice program from 25 or so years ago. (I have written about this in past years on other posts here). Carriers who joined this purchasing coop were forced to follow various, predetermined benefit designs (high, low medium) and could really only compete on network, reputation, and cost. Over time adverse selection caught up to the higher priced plans, who then exited, and the death spiral took over until the entire program lost out to plans that could offer different benefit/cost alternatives.
 
Not necessarily true. Premium costs would be developed by region or geography, as they are now

And when you change that region, it changes Premiums. It doesnt matter if the Premium adjustment is on the front end or the back end. Premiums are adjusted based on the Cost of Care, Cost of Care is region specific. So if people in a region with higher cost of care, suddenly can buy policies in a region with lower cost of care, that forces premiums to increase to account for the newer higher combined cost of care.

The viability of an association plan is a separate conversation. The ability for the plan to be national instead of state by state might make it more viable. They dont have a great history.

Selling accross state lines will only get us closer to single payor imo. Eventually, the entire individual market will be in the same risk-pool. At that point it will likely just be 1 carrier nationwide.
 
Last edited:
Back
Top