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Trump to Sign Executive Order on Health Care
- Thread starter SwordStruck
- Start date
Selling across state lines doesn't mean what people think it means. Companies can already sell insurance plans in whatever state they want, they just have to sell insurance that meets that state's regulations. "Selling across state lines" basically means states lose their ability to regulate insurance markets how they like because insurance companies would be able to sell shitty insurance that meets republican standards in New York and New York wouldn't have a say.
Oh, and it's already possible for states to set up agreements with other states to sell across state lines under the ACA -- a few states tried it out, but virtually no insurance companies took them up on the offer because our system is so inefficient with corporate bureaucracy that setting up insurance in a new state, coordinating with all the individual hospitals and doctors to set rates and build a network etc, is a nightmare. Competition = lower margins so insurance companies are naturally incentivized to divide and conquer different regional markets instead of directly competing with each other, sorta like ISPs.
But if for some reason insurance companies did start doing it, the prediction is that some republican state would tear down as many regulations as they could to try and attract all the insurance jobs, then those shitty plans would be sold across the country -- and they might very well be cheaper because they'd cover less and have more restrictions, so healthy people would flock to them and people that actually need insurance would be stuck on actual healthcare plans because they need healthcare and the lack of healthy people on those plans would inevitably cause premiums to rise which would collapse the market.
And if you hadn't noticed, this idea is pretty hypocritical coming from republicans because it's an extremely anti-states rights idea to basically forbid states from setting their own regulations for what health insurance can be sold in their own state.
https://www.nytimes.com/2015/09/01/...sell-health-insurance-across-state-lines.html
Oh, and it's already possible for states to set up agreements with other states to sell across state lines under the ACA -- a few states tried it out, but virtually no insurance companies took them up on the offer because our system is so inefficient with corporate bureaucracy that setting up insurance in a new state, coordinating with all the individual hospitals and doctors to set rates and build a network etc, is a nightmare. Competition = lower margins so insurance companies are naturally incentivized to divide and conquer different regional markets instead of directly competing with each other, sorta like ISPs.
But if for some reason insurance companies did start doing it, the prediction is that some republican state would tear down as many regulations as they could to try and attract all the insurance jobs, then those shitty plans would be sold across the country -- and they might very well be cheaper because they'd cover less and have more restrictions, so healthy people would flock to them and people that actually need insurance would be stuck on actual healthcare plans because they need healthcare and the lack of healthy people on those plans would inevitably cause premiums to rise which would collapse the market.
And if you hadn't noticed, this idea is pretty hypocritical coming from republicans because it's an extremely anti-states rights idea to basically forbid states from setting their own regulations for what health insurance can be sold in their own state.
https://www.nytimes.com/2015/09/01/...sell-health-insurance-across-state-lines.html
Some states already allow this, granted the insurer can meet their requirements.
Done at a federal level, we're going to see plans being offered dirt cheap that provide essentially next to nothing for coverage. It's going to be like the proliferation of shitty, high interest credit cards - only with healthcare insurance.
Done at a federal level, we're going to see plans being offered dirt cheap that provide essentially next to nothing for coverage. It's going to be like the proliferation of shitty, high interest credit cards - only with healthcare insurance.
Local networks and state based regulation have nothing to do with each other. They can leave the networks as they are, redefine their corporate HQ as whatever office they already have in a low regulation state, and proceed to start slashing quality of care in policies without changing anything about provider networks. They're two completely different issues.
Yes, the entire thing is a regulatory capture into a race to the bottom.
ZombiePlatypus
Member
Sorry , this is probably going over my head, but I'm not seeing how "allowing insurance companies to sell healthcare across state lines" = "People who aren't healthy and need healthcare will be passed over." Will insurance companies be allowed to pick, choose and completely ignore regions and groups of people? Isn't the whole point of ACA that you are guaranteed to have access to healthcare in some form?
Unless I'm totally missing something, I feel like access to different plans across state lines should have been a part of ACA from the start. What was the logic in limiting this consumer choice?
Did you read the links?
To be fair, so long as the minimum standards of ACA continue to apply, the amount of damage done won't be as bad. But if the Republicans should ever successfully overturn it, we'd be in a market we've never been in, almost certainly worse than the one prior to the ACA. You'd have policies written from states with effectively no regulatory minimums. And while consumers buying their own insurance could easily skip those, the vast majority of people get their insurance from their employer and have no say over its quality.
ZombiePlatypus
Member
I only read FactCheck one , and it seems to be suggesting that it'll lead to lack of standards? Isn't there language in ACA that insures at least some minimum level of regulation regarding what healthcare someone has access to?
Edit: Besada beat me with an answer to my own question.
State Freedom be damned. Too bad ACA didn't enforce something tighter on a federal level from the get go.
evil solrac v3.0
Member
all these half assed measures when this country can pay for health care for all ten times over. what a disappointment this country is.
ZombiePlatypus
Member
Only thing I can take comfort in is if they make it crash and burn, hopefully the public's backlash will lead to real universal, single payer across the country on a federal level.
It'll probably do nothing, as states are already free under the ACA to agree with other states to allow cross-state plans -- in the states that did set that up, virtually no insurance companies bothered to follow through and sell across state lines. That's if ACA's minimum requirements stay in place.
But letting insurance companies sell a plan that meets Louisiana's regulatory requirements in New York wouldn't necessarily mean they're combining the pools of Louisiana and New York. His order would have to mandate that pools be merged across all states they operate in -- not sure if that's possible with an EO or if they even want to mandate that (they generally don't like mandating things to corporations so I'm leaning toward no).
AnotherDayAnotherDollar
Banned
This is a good idea.
Aaron Strife
Banned
It really isn't but okay
Its a for-profit business that takes advantage of the one thing most citizens cherish above all else, the welfare of themselves and their loved ones. One party is trying to promote this concept, the other wants to limit and end that horrid practice. In the meanwhile they are left piling on as many protections and regulations as possible to prevent a nightmare scenario where only the wealthy can afford life, and half of America is too fucking stupid to see this going on in plain sight.
To me this sounds like a "Starving The Beast" strategy, reduce the quality, get public opinion against it, claim it is failing and finally try again to repeal it. Very sneaky move. I'm scared about that happening to our NHS.
For you guys who need the ACA as it is (Or hopefully to be improved) this has got to be a nightmare that never seems to end.
For you guys who need the ACA as it is (Or hopefully to be improved) this has got to be a nightmare that never seems to end.
Yoshi
Headmaster of Console Warrior Jugendstrafanstalt
There is a super easy fix: Tax-based health insurance: Everyone in the country has full coverage, payed for by a new healthcare tax. No one can opt out or choose a private company instead. It is easy, though certainly not republican style politics.
SoulUnison
Banned
So one of the main criticisms of the Obama administration was it's apparently overreaching use of executive orders, but this guy comes into office, tries to get the same thing done over and over again unsuccessfully for 9 months, being blocked and voted down at every possible turn, and keeping the ongoing process increasingly secretive because he knows there's nearly no support behind it "from the people," and his solution is almost literally "Well, I'm the President so now I'm going to FORCE you to do it."
Who is this tragic clown that's attained our highest office with absolutely no understanding of higher politics?
Why was that a massive selling point to his base considering he's basically trying to - possibly illegally - force something into law that carves a downhill slope directly against their best interests?
Why, that sounds like Socialism, and why should I have to contribute to society once I've amassed enough to not have to need anything back from it?
Who is this tragic clown that's attained our highest office with absolutely no understanding of higher politics?
Why was that a massive selling point to his base considering he's basically trying to - possibly illegally - force something into law that carves a downhill slope directly against their best interests?
Why, that sounds like Socialism, and why should I have to contribute to society once I've amassed enough to not have to need anything back from it?
Twig and Berries
Member
Except there are already exceptions in place allowing insurers to do exactly what you're describing in multiple states but they don't because healthcare is delivered locally.
I don't even understand this. How does this even lower costs? Insurance prices aren't that wildly different across state lines. They're high as fuck everywhere.
I mean I have Kaiser here in CA and love it, but my dad out in Mississippi can't get Kaiser since they have no facilities there. How does that help him or anyone there who wants Kaiser? (Assuming they'd want another similarly priced insurance option)
I mean I have Kaiser here in CA and love it, but my dad out in Mississippi can't get Kaiser since they have no facilities there. How does that help him or anyone there who wants Kaiser? (Assuming they'd want another similarly priced insurance option)
That's the ACA in a nutshell since it's been passed.
It was always meant to be a first step, instead it was kneecapped at the starting gate and then starved from there by GOP and right wing states that refused to take part in the 'optional' parts that would make the lives of their citizens better.
What legal basis does the executive branch have for overruling states' regulations regarding insurance plans? Is the argument that this would fall under the commerce clause generally?
There is some universe where this would be a sensible step towards a more coherent and less burdensome regulatory system. Of course this is not that universe.
There is some universe where this would be a sensible step towards a more coherent and less burdensome regulatory system. Of course this is not that universe.
They made it a business run by business folks who want more money
No it shouldn't.
States have the right to protect citizens of their states. This is going to lead to a handful of wild west states with minimal standards and zero oversight allowing insurers to set up shop and skirt all of the rules. The insurance will be "cheaper" but there will be no way to enforce protections for consumers.
California and New York have been keeping the life and health insurance industry in check for years almost single handidly by requiring specific policy provisions within those states that have forced better coverage to smaller states where it isn't commercially viable to give them their own insurance policies.
N21
Member
Can't wait to buy so many foreclosures!
Shy Fingers
Banned
The State's Rights crowd will surely be against this right? ...right?
But as long as Obamacare stands, wont those rules apply to these national plans?
D
Deleted member 284
Unconfirmed Member
Could this potentially be like AutoInsutance where insurance purchased in Alabama must provide the minimum insurance required in NY for an insured accident in NY? If so, I cant see insurance companies running to do this. Plus the increased cost of providers in another state would be very problematic, no?
badcrumble
Member
Yeah, at the very least this pretty clearly falls outside the purview of executive orders, or the GOP wouldn't have been trying to cram it into *bills* for the past few decades.
As someone who works in health insurance IT, the whole "selling across state lines" is an incredibly stupid, vacuous talking point that needs to go away. Most rating for individual market plans is done on a localized, county-wide basis already, and getting rid of state lines ain't gonna change that.
Additionally, all of the major insurers play in multiple states already, just acting as subsidiaries of the same company. It's not as though there is some groundbreaking insurance company that is shackled off in a single state somewhere begging to offer lower premiums.
But hey, if this allows Trump to think he actually did something, I'm all for it. Let Lamar Alexander and Patty Murray actually work together to do some bipartisan patchwork that might mean a damn thing.
Additionally, all of the major insurers play in multiple states already, just acting as subsidiaries of the same company. It's not as though there is some groundbreaking insurance company that is shackled off in a single state somewhere begging to offer lower premiums.
But hey, if this allows Trump to think he actually did something, I'm all for it. Let Lamar Alexander and Patty Murray actually work together to do some bipartisan patchwork that might mean a damn thing.
T
thepotatoman
Unconfirmed Member
Republicans always say that the insurance would still have to follow the state's regulations, which basically means this would do literally nothing, because insurance companies won't want to do that. I don't know if that's a lie or how this will work.
Basically it could be a loophole around state regulations, or could be just the same as doing nothing.
Even as a loophole, it's possible insurance companies wouldn't use it given the complications of including multiple markets, unless it's as simple as a california insurance company saying they're based in Alabama now while they continue basically exclusively making plans for California markets.
Basically it could be a loophole around state regulations, or could be just the same as doing nothing.
Even as a loophole, it's possible insurance companies wouldn't use it given the complications of including multiple markets, unless it's as simple as a california insurance company saying they're based in Alabama now while they continue basically exclusively making plans for California markets.
Exactly. Because I can't imagine that "selling across state lines" means bypassing state regulations for certain plans, the only money I can think that could be saved by doing this is allowing health insurance to consolidate administrative functions to low-tax states. This might save health insurance companies a non-trivial amount of money, but I don't know if it would be enough to fundamentally lower premiums.
TheSecondSpitter
Member
Thread title should read "Trump to Sign Executive Order 66 on Health Care"
N21
Member
He should be careful as there was an order that allowed the senate to take down the chancellor if needs be.