How the hell does “allowing people to purchase insurance over state lines help”?

[busterbrown]

This is the main center piece of the Repubs. attempt to fix the healthcare crisis.

Ted Cruz used this piece of shit solution today.

Great article by Joan Walsh..


http://www.salon.com/2013/11/20/ted_cruz_reveals_hes_a_thin_skinned_hypocrite/

[hollysmom]

1. having worked on insurance systems across state lines

it just confuses things,State laws change fast and it was hard and tricky to make a system that accommodated all those laws and could be changed several times a day.
what I think they are talking about is make it legal in the state selling the insurance - then it will be like incorporation, because of taxes most companies incorporate in Delaware. The insurance companies would just go to the lowest point for writing policies.

[busterbrown]

4. Thanks, but I don’t get it..

Please break it down to my 8th grade understanding level.. If I’m in Alabama without Medicaid help. Single, 40 and make 40 grand ,Would I just get on the Web and shop other states for the best price.. Why would North Carolina or any other state have better plans? For example?
Don’t all insurance companies basically have the same fucked up Premium Plans.. Maybe one would be $20 less a month. But aren’t they basically the same junk unless your willing to pay a lot more?

[former9thward]

5. We buy auto insurance across state lines.

There is no difference. Medical insurance is governed by the ACA which is a federal law so the "state laws change fast" has nothing to do with it.

[hollysmom]

22. Sorry, what i was trying to say

was each state passes laws about what insurance has to have separate rules for insurance sold in each individual state. When you buy auto insurance across state lines, that insurance company has to manage so they meet the state rules in your state. But,if I am interpreting this correctly, the insurance company for health insurance would only have to meet the state laws in the state they are issued in. Many insurance companies already operate across state lines and they meet the laws of the state you live in. The way I read the republican idea is that they want the insurance company to meet only the rules in the state they are based in. So they will move to the state that has the fewest rules and regulation. And you get lousy insurance.

[former9thward]

24. No, that's not it.

First, I don't know what the Republican proposal is so I am not commenting on that. But medical insurance has to meet the federal standards -- not state standards. State standards have been pretty much nullified by the ACA.

[Keefer]

31. Not entirely true

Each state has a commissioner that is in charge of insurance regulations for each state. That's why some states, nine I think, have come out and said they will not be offering their old, (cancelled,) plans. The insurance commissioners made those decisions.

[riqster]

33. Not completely correct. The only state insurance regulations that were invalidated by the ACA

...were those specifically contradictory to the ACA. There are loads of arcane and Byzantine rules and regulations in each state that remain in force.

[hollysmom]

35. yes but the states have rules as well

a lot of it can just be wording. remember just trying to print out a contract was a pain because different states needed different phrases in their contract. Trust me the states still have their own sets of rules.

[VanillaRhapsody]

26. Exactly....it's why credit card companies are always located in certain states...

the states that regulate them the least.

[otohara]

34. Is Insurance More Expensive In The South?

Wondering about the unhealthy vs healthier states.
What about states where there's high uninsured like Texas?

[Sanity Claws]

2. I think it's an attempt to prevent states from regulating insurance

Insurance has traditionally been regulated by the states. Your state probably has an Insurance Commissioner. If there is a federal law allowing insurers to sell across lines, it will mean that state regulation is preempted.

When Congress passed ERISA, employer-provided insurance was now regulated by the feds and preempted from state regulation and law.

That is my take on it.

[Laelth]

6. +1. n/t

-Laelth

[doc03]

3. Beats me, but they don't believe in competition or importing pharmaceuticals n/t

[pilar007]

7. not sure but...

I thought state to state healthcare shopping was part of the ACA.

[busterbrown]

8. The Medicaid is purely run internally by the state which chose to accept it..

A person who lives in Georgia can not participate in a plan run by Cali...

[antigop]

9. according to Wendell Potter, it won't...it's already been tried

http://www.huffingtonpost.com/wendell-potter/romneys-phony-answers-to_b_1948449.html

High on the list of recommendations in Romney's health care platform is an idea frequently touted as a silver bullet by conservatives: allow insurance companies to sell policies across state lines. Doing so, they say, will increase competition and, consequently, bring down the cost of coverage.

The problem is that no one had done a study to determine definitively whether the across-state-lines idea would work -- until now. And the conclusion of that study, conducted by the Georgetown University Health Policy Institute, is that allowing coverage to be purchased across state lines is much more of a blank than a bullet.

The study also finds that no new federal law is even needed to allow insurance companies to sell policies across state lines.

"With or without changes to federal law, states already have full authority to decide whether or not to allow sales across state lines and, if so, under what circumstances," the study noted.

Of course, you wouldn't know that from listening to Romney and other politicians who seem to believe than an act of Congress is needed. It isn't. State legislatures can make it happen whenever they want, but, so far, only six have decided to try it. Georgia, Maine and Wyoming have enacted legislation in recent years to allow out-of-state insurers to sell policies within their borders. Lawmakers in Kentucky, Rhode Island and Washington passed bills requiring their insurance departments to research the idea and determine interest from out-of-state insurers.

The lawmakers who championed the legislation expected their states would be inundated with applications from insurers far and wide eager to sell their policies. But it hasn't happened. In fact, not a single insurance company has expressed the slightest interest in doing business in any of those six states.

[busterbrown]

10. And Yet Andrew Cuomo did not have the facts which you just presented.

Although he did an o.k. job with Cruz he should have been prepared with the info you presented here.

Thanks!!

[antigop]

11. but just fyi...Congress included multistate insurance option in 2010

http://www.nytimes.com/2013/09/30/us/politics/us-plans-to-unveil-new-insurance-options.html?_r=0

The Obama administration plans on Monday to announce scores of new health insurance options to be offered to consumers around the country by the Blue Cross and Blue Shield Association and the United States Office of Personnel Management, the agency that arranges health benefits for federal employees, according to administration officials.

The options are part of a multistate insurance program that Congress authorized in 2010 to increase options for consumers shopping in the online insurance markets scheduled to open on Tuesday.

Congress conceived multistate plans as an alternative to a pure government-run insurance program — the “public option” championed by liberal Democrats and opposed by Republicans in 2009-10.

“The multistate program will help deliver choice and high-value health plans in the new marketplace, expanding quality, affordable options for uninsured Americans,” an administration official said.

[busterbrown]

12. But I just don’t get it..

Aren’t the multi state programs still the same" for profit bullshit"

[antigop]

13. well, they are set up through Blue Cross Blue Shield-- isn't BCBS non-profit?

I don't think they are publicly traded, like Aetna and United Health.

I'd have to check.

[busterbrown]

14. But Non-Profit does not mean that execs can’t make millions...Correct?

They need to make their millions...

[antigop]

15. absolutely true. But they don't have to worry about keeping their stock price up if they are not

publicly traded. Wendell Potter wrote about BCBS...I'll try to find it.

[busterbrown]

17. Well we’re on the same page.. Thats for sure.

For Profit Healthcare Businesses suck..

[antigop]

19. yes, they do.

[antigop]

16. here it is....

http://www.huffingtonpost.com/wendell-potter/blue-cross-blue-shield-ge_b_856207.html

[antigop]

18. correction...technically I think there are limits if you are structured as a non-profit

I *think* (not sure) you might be asking for a trouble if you pay your execs too much. I would think your IRS tax exemption might come into question.

I'm not an expert on non-profits.

But as Wendell Potter explained in his article, you can build fancy palaces and spend your money in other ways.

[busterbrown]

20. What about this?

http://www.kionrightnow.com/global/story.asp?S=9980150

[antigop]

21. dunno...that says Anthem Blue Cross is for profit.

But Wendell Potter's article says BCBS is non-profit.

Sorry..I can't help.

[VanillaRhapsody]

27. BCBS USED to be non-profit...that changed years ago..

my sister has worked for them for a long time...

[Sunlei]

23. How about people can use the insurance exchange for any state?

All the Federal dollars go through auto bank deposits anyway. The insurance exchanges are all the same exact insurance companies for 50 different states.

I'd rather have states with smooth insurance websites and expanded medicare handle our Federal billions anyway, instead of states like Texas.

[antigop]

25. buster, I did find this....it hits the rightwing talking points

http://www.ncpa.org/pub/ba630/

Basically, the argument is that some states have more mandates than others...so people should be able to buy their policy from a different state that may have different types of offerings that are allowed by that state.

People shouldn't be restricted to their own state's mandates.

(Don't shoot the messenger...I think it's bullsh*t.)

[VanillaRhapsody]

28. mandates meaning the dreaded "regulations"

[antigop]

29. yep. nt

[antiquie]

30. Rates and subsidies vary by state.

As does the cost of doing business. Compare California and Montana for both subsidies and premiums and you will better understand the problem with cross-state policies -- policies, not the insurers.

[busterbrown]

37. I presume your talking about non ACA issues...

Are you then telling me that (exempting discussion of ACA) that if I’m living in Montana, I will find a much better Insurance plan in Ca. I live in Cali and believe me there are no good plans here which don’t cost a mint..

Regardless, we are putting the whole ball of wax back in the Healthcare Companies!!

[antiquie]

38. ACA.

Montana vs. California.
Try it yourself.
I live it SoCal and the ACA will negatively impact me.

[busterbrown]

39. Huh, Please explain how because you can’t buy insurance from Montana...

It i’ll cost you.... Be specific.. I’m interested...

[antiquie]

40. I don't want to.

[busterbrown]

42. I wonder why?

Perhaps.....You should try to educate yourself why your here..

[antiquie]

43. What is your problem?

It seems you do not want to understand.

Insurance premiums and medical costs and cost of living in general vary greatly by state. This is reflected in the Exchanges. In California, the rates vary between counties. The subsidy is based on many factors, including the percentage of your income the premium is, as well as the size of your household and geographic location.

I am quite well educated on this subject. How about you?

[busterbrown]

44. But how is your ability to cross state lines and buy Insurance from another State

going to help you.. How the Hell is the Republican Plan more helpful to you?

[antiquie]

45. This is my last attempt at discourse with you.

I have been speaking of what is available through the Exchanges, and some of the differences.
I have never indicated I wanted to purchase anything across state lines.
I have no idea where you got that idea.
I am so far left of President Obama that your accusation that I prefer the Republican plan is ridiculous.

I want health care, not health insurance.
I take care of myself at 63 and have not seen a doctor since 2007, when I was last insured.

[busterbrown]

46. I’m probably getting you mixed up with someone else...Sorry.

63 is just an awful age when it comes to health insurance thats why I posted this thread,,
I guess the Cover California doesn’t help because you make too much..
Up here in L.A. I believe it’s $17,000..

But she used Cover California already and its good..

[tridim]

32. It doesn't, it's just something teabaggers say because they are idiots with no ideas.

They know that the people who vote for them without question are idiots as well.

[Wounded Bear]

36. Like most Repub ideas, it's an end around...

You can already "deal insurance across state lines." That's the start of the lie.

What they really want is to circumvent the state insurance commissions that regulate the insurance industry. That way, they can do the typical race to the bottom.

What they want is to force states into competition to relax their insurance regulations so that they can job shop to the state with the most lax rules and sell using those rules in all 50 states. Not a very "states rights" attitude, of course, but when did they ever let their own ideology stand in the way of profits?

So basically, if your state happens to have good consumer protections, Repubs want to be able to get around that.

[busterbrown]

41. Ah, an answer....Someone above is stating that they will loose money

if the ACA does not include shopping over state lines... I don’t know what he is talking about... Trying to get more info from him.. His answers are short and curt.. Typical..