Fixes, fast and furious
The executive summary is that Ron Johnson wants to ensure that individuals can keep their current plans and also add family members as necessary. Mary Landrieu wants to ensure that individuals can keep their current plans, but nobody else can get on. And Fred Upton wants to ensure that individuals can both keep their plan and that new individuals can continue buying plans, but only through 2014.
And President Obama hasn’t proposed any changes to the law, but he is crossing his fingers behind his back and telling insurers that even though these plans will remain illegal, he’ll wink at any transgressions and not enforce the law, no way, won’t you please break the law for me? You can tell he’s sincere because he’s promised to veto the law congress wants to pass to legalize what he’s asked insurers to do.
States and insurers are oddly not lining up for the President’s “fix”. If you think it’s confusing, imagine that you’re the state regulator having to take it into account, or that you’re a member of an insurance company’s legal staff tasked with giving advice to the board on whether they should or should not break the law at the President’s request.
Meanwhile, Marco Rubio has noticed that there’s an unlimited bailout for insurance companies hidden in Obamacare’s two thousand pages. His bill—not yet introduced—will remove that provision to ensure that taxpayers are not on the hook for lowballed insurance rates causing a bailout later. Maryland has already attempted to force insurance companies to lowball their rates; at least one, Aetna, chose to leave Maryland rather than join Maryland’s scam on taxpayers.
Since it’s the states that have set up exchanges that are most likely to try this scam, it’s important that Rubio’s bill not allow states to force insurance companies to make off-exchange policies pay for exchange policies. That is, the bill needs to make sure that insurance companies will have to charge enough on the exchanges to cover what they are going to pay out under the exchanges. Otherwise, the true cost of the exchanges will be hidden.
The “Promise” bills are all flawed in important ways, although the Upton bill is marginally the best. The other bills do little more than delay the day of reckoning. Upton’s bill fulfills the need of firewalling the failure—but only through 2014.
If insurance companies are going to be convinced to keep offering private insurance outside of the exchanges, it is absolutely necessary that they be allowed to sell it to new customers; otherwise, their pool of non-exchange policies dwindles every month and becomes more subject to the vagaries of chance.
I really think the new starting position for the GOP needs to be that people, insurance companies, and health care providers are allowed to opt out of the exchanges and the ACA regulations completely. Even to the point of not having insurance if they don’t want it. Make them affirmatively opt out—force them to make a choice—but let the ACA die by firewalling its failures rather than making “incorrect promises” to fix them. If I’m wrong and the exchanges, unlike the California exchanges, actually work, well, they’ll succeed in the marketplace, competing against non-exchange policies.
That plus, potentially, the Rubio bill, would quarantine Obamacare’s failures into a smaller and smaller problem, making it progressively easier to find a solution.
Obama, of course, has threatened to veto the Upton bill (and most likely the Landrieu and Johnson bills as well). To greater and lesser extents, these bills maintain a private insurance market outside of the exchanges. By existing alongside the exchanges they will make it obvious how bad of a deal Obamacare is. People will be able to compare private insurance to exchange insurance—prices, deductibles, and coverage.
But another lie in the making is that the Affordable Care Act calls for a bailout to insurance companies if payouts exceed payins under the exchanges. This allows, as Maryland tried to do, selling exchange policies under cost and bilking taxpayers for 80% of the rest. That is, the cost of policies won’t decrease, merely how they get paid for. That’s what Rubio’s bill fixes.
If Republicans are going to acquiesce to a fix, it should be that insurance companies can continue to sell non-exchange policies that are fully separate from the exchanges, and do not subsidize exchange policies. This will make the differences between the exchanges and private insurance obvious.
Here’s a summary of the current bills I’m aware of for enforcing President Obama’s promise:
-
Ron Johnson’s Senate bill, S.1617
- Individuals can keep their current plan
- Family members allowed to join current plan
- Otherwise, no new customers are allowed
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Mary Landrieu’s Senate bill, S.1642
- Individuals can keep their current plan
- Neither family members nor new customers are allowed
-
Fred Upton’s House bill, H.R. 3350
- Individuals can keep their current plan
- New customers can join existing plans
- But this only lasts through 2014
The best solution is H.R. 3350’s open market combined with S.1642’s unlimited duration.
In response to Why we must not ration health care: Rationing health care means fewer cures.
bills
- H.R. 3350: Keep Your Health Plan Act of 2013: Representative Fred Upton
- “To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.”
- S. 1617: If You Like Your Health Plan, You Can Keep it Act: Senator Ron Johnson
- “To amend the Patient Protection and Affordable Care Act to ensure that individuals can keep their health insurance coverage.”
- S. 1642: Keeping the Affordable Care Act Promise Act: Senator Mary Landrieu
- “To permit the continuation of certain health plans.”
ObamaCare
- Aetna withdraws from Maryland insurance market after state demands lower rates in health insurance exchanges: Caroline Humer
- “In an August 1 letter sent to the Maryland Department of Insurance, Aetna said the state’s requirement for rate reductions off its proposed prices would lead it to operate at a loss. The rate reductions include products from Aetna and Coventry Health Care, which it bought this spring.” (Hat tip to Erika Johnsen at Hot Air)
- Firewall affordable care act failures
- Because Senate Democrats are not going to repeal the mess that is the ACA, we need to firewall the failing parts of it in order to keep health care and health insurance costs from escalating too much.
- Is the Administration Offering Insurers an Obamacare Bailout?: Chris Jacobs
- “The Centers for Medicare and Medicaid Services (CMS) today released guidance to state insurance commissioners implementing President Obama’s ‘fix’ for people losing their insurance. Not only does it violate the explicit text of Obamacare itself, but it also raises the possibility of insurers getting access to a new pool of bailout funds.” (Memeorandum thread) (Hat tip to Ace at Ace of Spades HQ)
- Oh, My: Rubio Wants to Repeal Obamacare’s Pre-Planned Bailouts for Insurance Companies: Ace at Ace of Spades HQ
- “This was of course a bribe to insurance companies, to get them to sign on to Obamacare. It’s not that it put money in their pockets, exactly; but it did indemnify them against Obamacare losses… But now Rubio wants to put insurers in the same place as citizens—fully exposed to the wrecking-ball harms of Obamacare.”
- The President just threatened to veto our bipartisan bill to allow you to #KeepYourPlan.: Eric Cantor
- “If presented with Keep Your Health Plan Act H.R. 3350 the President would veto the bill.” (Hat tip to Ace at Ace of Spades HQ)
More ObamaCare
- Community health acts to improve Obamacare
- Democrats now want to talk about how to improve Obamacare. Here’s how to do it.
- Democrat Chris Murphy: Obamacare is “the end of health care”
- From the mouths of hypocrites, comes wisdom. It’s almost biblical.
- Health insurance reform? What health insurance reform?
- The Truth About Republicans: they don’t want to repeal Obamacare.
- Economies of scale and government-run health care
- Economies of scale only produce lower prices when people are allowed a choice of service providers—including the choice to forego the service. Government-run programs do not benefit from economies of scale—in fact, scaling up will cause increased prices when the industry is run by the government.
- A tale of two negotiators
- If you want to see how Republicans in Congress fail to pass successful reforms, compare the House Obamacare “repeal” with the White House’s budget.
- 16 more pages with the topic ObamaCare, and other related pages