Trump Won, Vows Day 1 Full Repeal. Lets Discuss.

[goillini52]

Most companies don't service a whole state in the first place. Allowing purchasing over state lines makes no sense when the plan is only available to zips within a state! Carriers would be forced to rate every zip in the nation, for every product, every year. Beyond the actuarial nightmare, this means carriers will effectively compete against themselves. There's 4 BCBS's in my state alone (Empire, Excellus, Anthem, Western), for example. Not to mention, the consumer would now have to choose a plan from THOUSANDS of options, with no standardization of benefits.QUOTE]

They already do that with Medicare Supplements and Dental Insurance. I could've sworn they did that with Major Medical before O'bamacare.

 

[RayNY]

They already do that with Medicare Supplements and Dental Insurance. I could've sworn they did that with Major Medical before Obamacare.

Carriers only filed rates for the zips in which they were selling. There was never a requirement to make a product available outside of your service area, which is what the "buying over state lines" concept proposes. Most carriers are regional, and even "national" carriers like BCBS are just an association of multiple independent companies (36 regional carriers in BCBS's case).

I have rate filings and records for local carriers going back to the 1980's sitting in my office. Many don't even have filings for the entire state, let alone, nation. They only rate for their service area. It's always been like this as far as I know.

 

[goillini52]

Carriers only filed rates for the zips in which they were selling. There was never a requirement to make a product available outside of your service area, which is what the "buying over state lines" concept proposes. Most carriers are regional, and even "national" carriers like BCBS are just an association of multiple independent companies (36 regional carriers in BCBS's case).

I have rate filings and records for local carriers going back to the 1980's sitting in my office. Many don't even have filings for the entire state, let alone, nation. They only rate for their service area. It's always been like this as far as I know.

I realize that about the regionality(is that a word...lol), but won't the carriers be able to decide if they want to sell across state lines or not?

 

[VolAgent]

I realize that about the regionality(is that a word...lol), but won't the carriers be able to decide if they want to sell across state lines or not?

Then they will rate for the zip and we'll be right back where we started. Also, they will need to put together or find a network for the area.

 

[goillini52]

Then they will rate for the zip and we'll be right back where we started. Also, they will need to put together or find a network for the area.

Wouldn't that be better than where we are now? The one thing I like about O'bamacare is that those with pre-existing conditions can get coverage...but we didn't need to turn the system upside down to do this. Many of the uninsured before O'bamacare chose not to have any. It would've been much cheaper to give free or subsidized coverage to those that couldn't qualify for coverage.

 

[VolAgent]

Wouldn't that be better than where we are now? The one thing I like about O'bamacare is that those with pre-existing conditions can get coverage...but we didn't need to turn the system upside down to do this. Many of the uninsured before O'bamacare chose not to have any. It would've been much cheaper to give free or subsidized coverage to those that couldn't qualify for coverage.

Would it? Who knows. I agree, I'm not a huge fan of Obamacare either.

Ultimately, we are arguing about the symptoms and not the cause. Until the growth in the demand for care and its costs slow down, then health care costs will continue to rise. And if health care costs rise, so will health insurance.

 

[RayNY]

Ultimately, we are arguing about the symptoms and not the cause. Until the growth in the demand for care and its costs slow down, then health care costs will continue to rise. And if health care costs rise, so will health insurance.

We're all in agreement on this fact. Insurance is merely the financing method to pay for the costs. You can't lower costs by regulating the payment method, that's like trying to make food cheaper by limiting credit card interest rates. Unfortunately, the lay person doesn't see it this way, and politicians seem to ignore this simple fact.

Then they will rate for the zip and we'll be right back where we started. Also, they will need to put together or find a network for the area.

Local carriers are sending more members to providers in that area. Thus, they have more negotiating power in that region. They have more accurate experience and risk profiles. Thus, they can have lower rates.

Why would BCBS Alabama rate my zip differently than BCBS Arizona, considering neither has network here and is paying OON reimbursements either way? You think they'd play with a slimmer margin of error than a carrier with decades of experience with my area?

I realize that about the regionality(is that a word...lol), but won't the carriers be able to decide if they want to sell across state lines or not?

What you imply is something that can already be done, nothing stops a carrier from expanding to another state and offering product.

There's 2 ways this actually gets implemented.

1. Anyone can buy a plan from any state, carriers are required to allow it. From what Trump has said, this is the implication I've gotten.

2. As long as your plan complies with regulations in the state you file, you can offer those plans in any state, even if it doesn't comply with that state's regs.

EX: NY has GI and prohibits pre-ex exclusions at the state level. We have "Timothy's Law", which requires specified benefits for mental/emotional/nervous illnesses.

A company in a state without those regulations could make a product that doesn't have any of that, and sell it in NY. Since GI, pre-ex, and additional mandatory benefits raise costs, a product without those benefits would be cheaper.

 

[somarco]

Four years ago, maybe five, Georgia passed legislation allowing out of state carriers to sell their product in this state.

To date not a single carrier has file for admission.

The sponsor of the bill, a P&C agent, was dumbfounded that no one wanted to sell here.

 

[VolAgent]

Four years ago, maybe five, Georgia passed legislation allowing out of state carriers to sell their product in this state.

To date not a single carrier has file for admission.

The sponsor of the bill, a P&C agent, was dumbfounded that no one wanted to sell here.

Ignoring the various BCBS organizations and the ACA co-ops, are there any non-national health insurance companies? Were there any when the bill was passed?

Our BCBS doesn't even wish to serve the entire state any longer. Why would they want to sell insurance in some other state, to double their enrollment and double their losses?

 

[somarco]

There are very, very few regional health insurance carriers any more. At the time there were players (in a manner of speaking) like Celtic and World. Both of those bailed before 2014. I am sure there were more.