The Wyden/Brown plan


Erik Kain

Erik writes about video games at Forbes and politics at Mother Jones. He's the contributor of The League though he hasn't written much here lately. He can be found occasionally composing 140 character cultural analysis on Twitter.

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8 Responses

  1. Avatar Pat Cahalan says:

    > I agree with Reihan that conservatives should push for more room
    > to experiment with market-based or consumer-driven approaches.

    Sure; but to be fair, there has to be an API somewhere. What happens when someone from a non-market driven approach state relocates to one that does? Or the other way ’round?

    If I’m a citizen of “free market” state, passing on everything except the cheapest possible catastrophic coverage with a really high deductible, and I get leukemia, how easy is it for me to move to a full-coverage state with no deductible?

    Assuming these sorts of free-rider riders are taken care of, I like the idea of diverse attempts to tackle the same problem. I’m not convinced, in the case of insurance, that they will be.

    It also seems sort of weird to talk about wanting to have larger risks pools and then be proposing an approach that will by nature create smaller risk pools (at least, smaller than “everybody”), E.D. How do you reconcile that?Report

  2. Avatar Underwriterguy says:

    Hope this isn’t too much “inside baseball,” but the advantage of selling across state lines has nothing to do with risk pools and everything to do with avoiding costly state mandated benefits. Any national HMO or insurance company basically looks the fully insured book of business as a whole and then makes rate adjustments to fit locality, etc.Report

    • Avatar Brett says:

      The “advantage” of companies being able to sell policies across state lines is that they can then do what the credit card businesses did, and cherry-pick the states for one that will basically let them write the insurance regulations in exchange for headquartering there.Report

      • Avatar Underwriterguy says:

        As someone who spent over 30 years in the industry, I beg to disagree. First, unlike banks, insurance companies don’t domicile in order to be regulated. They are regulated in every state in which they are licensed. That is, a company domiciled in PA and doing business in PA and AZ is regulated by both PA and AZ. Many confuse state regulation, including solvency issues, with state mandated benefits.
        Selling across state lines means that consumers in a state like NY, which has many mandated benefits, would have the option of buying a plan design approved for sale in a state with fewer mandates, thus paying a lower premium. The insurance company selling a non-NY plan in NY would still be regulated by NY and pay premium taxes on NY sales to NY. Consumers, or employers who purchase on behalf of their employees, would have additional choices. And remember, large employers, who self insure, are exempt thru ERISA from all state mandates. Selling insured products across state lines would give small employers and individuals the same rights as large employers.Report

  3. Avatar tom van dyke says:

    ” If a state can think of a plan that covers as many people, with as comprehensive insurance, at as low a cost, without adding to the deficit…

    This is a joke, right?Report

  4. Avatar Simon K says:

    I guess I don’t really understand what “as comprehensive” means, and no-one seems to be explaining. Surely what we care about is whether people have access to healthcare, and whether the conditions under which they do it are fair? I’m not really sure how “comprehensive” plays into this. No scheme can cover all possible treatments for all conditions and all people and be affordable. Does a state scheme have to cover the same people as the federal one? Or the same conditons? Or the same treatments? Or what?Report

  5. Avatar zmanbeachcomber says:

    we have a good system medicade and medicare. what they need to do is fix it the right way. stop going into it to fund some pork programs and use it for the purpose that it was created for. we all pay into the system. what we have to do is tell these lawmakers on capitol hill is do the right thing by the people.Report