You know that 'buying insurance across state lines' is just the race to the bottom ...

[ThomWV]

I just want to make it clear, the changes in health insurance regulations proposed to allow people to cross state lines in their search for least expensive health care insurance are just the first stumbling block in the fall to the bottom of the insurance pit. The state with the least coverage and regulation will be the one where companies offer the least expensive insurance. The plans that emerge will be easy to find both from TV advertisements and On-line presence if this provision lasts to the final Bill - and while inexpensive they will be the ones with the least chance of the insurance company actually paying a claim if one is submitted and they will be the ones which will find every single loophole to deny coverage that can be found. And there will be competition to come up with this sham of a policy, there will be states that offer incentives to be the home of the company that comes up with the worst possible insurance - after all, simply housing them will provide jobs and revenue.

It will be a race to the bottom deserving of coverage on The Speed Channel. Think about it for a moment and it will occur to you how ironic that is.

[Nite Owl]

1. Did they agree to put that in the

bill? I know the GOP has that as a priority but I didn't think the dems agreed to it.

It would be awful if it was in there as well as their other fav tort reform.

[laughingliberal]

20. It's in the Senate bill, yes. nt

[Nite Owl]

23. Oh great, the damned bill is

bad enough without that too.

[laughingliberal]

29. There are so many poison pills in the Senate bill, I would grow old trying to list them all.

Okay, I'm already old. I'm not sure I'd live long enough to detail all of them. And I'm not sure I've even detected all of them yet.

[Nite Owl]

31. I'll be on Medicare in a couple

of years but my kids will have to suffer through all this.

[laughingliberal]

33. My husband just has 2 more years if we can keep him alive that long

I, OTOH, have 10 years left.

[Winterblues]

2. This push from the "State's Rights" Party...

States have the Right to Regulate Insurance companies.. Each state has different regulations. If Republicans get their druthers they would eliminate the State's Right to regulate..Democrats say Okay we will do it but only if Insurance is regulated by the Feds so all regulations are the same. Just another major hypocrisy from the Republican side...

[NoNothing]

3. I'm not convinced

A "race to the bottom" can occur if the only thing consumers care about is price, full stop. But I'm not convinced this is so, as concerns health insurance. Don't you think most people would consider factors like what is and is not covered, what doctors they can see, how many out-of-pocket costs there are?

[Winterblues]

4. Many times Employers, which buy the most Insurance, ONLY care about costs..

Not to mention how it would effect the State Insurance Regulaters..

[el_bryanto]

5. Yes and conisder that the race to the bottom won't last forever

Big companies who can afford to suck up losses for a while will consolidate and get rid of competition, at which point prics will rise back up, I would imagine.

Bryant

[luckyleftyme2]

7. YOU GET WHAT U PAY FOR

Ilive in Maine , when our state changed it's criteria for coverage to be offered by a minimum health care policy several insurers left our state! the reason this change took place was that so many Mainers found out the policy they had did not provide adequate coverage!
if it looks like a bargain it probably is an under coverage policy!

[ThomWV]

6. Here is the argument I'd give - if they can't afford coverage now, but are required to buy it by law

Then they will care more about price than they do about coverage.

I would agree with your argument for the vast majority of consumers - where it is the uninterrupted provision of health care when needed is the desired outcome - price will not be the deciding factor and policies that provide better coverage will be favored. What we will have in the future that we do not have now is mandatory coverage - so people who are not in the market now, a number estimated at 30 million, can be expected to gravitate toward the lowest cost policy that meet whatever minimum requirements that do find their way into law.

[laughingliberal]

19. These days there are a lot of people who can't afford to look at anything but the price

Everyone wants better coverage but economic realities being what they are, I think most are going to have to go for the lowest premium they can find.

This across state lines thing is a plank of the Republican ideas for HCR. There's a reason for that.

[Nite Owl]

27. And then they or someone in their

family gets sick and they find out they aren't covered for that illness, or not covered enough and they go bankrupt or die from lack of coverage. Sounds familiar. The bill does nothing for deductibles and they are not fully paid by the subsidies (which are only for the low end plans). All the Senate bill does is allow the healthcare industry to keep up their monopolies.

[CTyankee]

26. I would hope so but I can also see young, healthy people who believe they are indestructible

going out of necessity and denial to the cheapest policy and then, wham, a truck hits them and their coverage is...where??? Then what happens and who picks up the tab?

Of course, all of the sicker or older people will go to the higher priced policies that will continue to rise in cost as their costs go up, covering only sicker people.

That is the insidious nature of having this kind of "choice." It turns out not to be choice after all...

[Romulox]

8. Race to the bottom is the essential characteristic of capitalism. This is legitmate market behavior

People do not want to buy this product. So they will look for the bare minimum the government forces them to pay.

Your solution is to force them to buy the product from the people you dictate to them?

[Karia]

9. NT/ If you want to know what this will do to insurance, look at what it has done for credit cards

[leftstreet]

10. Once we're all at the bottom we'll be easier to 'manage'

K&R

[laughingliberal]

30. word nt

[Juche]

11. That is what happened with the credit card industry

It is actually worse than you describe. WIth credit cards, the companies found a small, conservative, struggling state and told them if they passed laws disempowering consumers, they would set up shop there which would bring jobs and tax revenue. So South Dakota did.

It isn't just a race to the bottom. WHat will happen is Blue Cross, Aetna an dall the other companies will find some right wing, economically destitute, small state and hand them legislation full of anti-consumer and pro-corporate language and tell them 'if you pass this, we will set up shop in your state and bring jobs and tax revenue'.

You need federal regulation if you have state to state competition.

[Romulox]

13. How is that any different than setting up a Kia plant in Alabama?

It's not different. Even a little bit. It's the basis of capitalistic competition, which is supposed to be the engine that drives the savings in this health care bill.

This is how they do it. A "race to the bottom" is the definition of capitalism. It's not an anomaly--it's the entire basis of the thing!

[jmowreader]

14. I thought they already had those laws

I know Delaware did, which is why Delaware was historically the credit card capital of America. The problem with Delaware is it got expensive to live there.

[jmowreader]

12. I already said why this is a bad idea, and it's not because of any "least expensive" bs

It's going to work like credit cards. If on Monday the government allowed people to cross state lines in search of the least expensive insurance, on Tuesday every health insurance company in America will be in the most expensive state in the Union buying real estate.

As strange as it sounds, there are justifiable reasons why health insurance costs more in West Virginia than it does in Utah. West Virginians engage in more unhealthy personal habits than Utahns do, and they work in more hazardous occupations. There is not one coal mine in Utah, you know that? People in WV are more likely to get sick than people in UT, and they're more likely to get sick with expensive diseases. Based strictly on risk it's logical to ask WV residents to pay more for their health care. But running around saying "we think the people who live in West Virginia should be able to pay the same amount for their health coverage as the people in Utah," like the GOP is doing, is patently stupid on its face. The Repukes know how stupid it is, too. They're just not telling you their secret agenda: they think the people in Utah should be able to pay the same amount for their health coverage as the people in West Virginia do, and they're setting up the mechanism that will allow them to do that.

[ThomWV]

15. You very much lost me in there somewhere ....

I understand the desire to segregate risk pools and the effects achieved by it if that's what you mean. But you are talking about risk-based pricing and I'm talking about policies which will come into being in which health risk of the insured has little to nothing to do with it. These will be policies in little more than name with bare minimum coverage at a price just a bit below anything market price for real coerage; and in the end will more resemble Pay-day-loans than present day credit cards.

[jmowreader]

36. Actually I'm not talking risk-based pricing if cross-border policies are allowed

Right now you've got risk-based pricing, and that makes sense: the states where smoking is epidemic are going to have lung cancer incidence higher than states with lower smoking rates. I think what will happen, is the highest rate in the country will be what we all pay.

[Abq_Sarah]

24. Allowing people to purchase insurance across

State lines would actually reduce the price of insurance in WV by spreading the risk across a much larger pool.

[jmowreader]

32. In a perfect world you are exactly right

But we're not talking about a perfect world. We're talking about insurance companies.

These assholes are going to find the state with the highest insurance rates in America, promise them a shitload of jobs if they don't lower their rates, and all relocate to that state.

[OneTenthofOnePercent]

16. Depends whether or not the minimum coverage provided is defined

by where the policy holder lives or where the insurance company is located. For example, if an insurance company sells policies in another state, policies sold in that other state must abide by that state's minimum standards. I simply cannot imagine that it would be by where the insurance company is located - that would make no justifiable sense and be a logistical nightmare.

I heartily support interstate competition if the minimum coverage is set by the policy-holders state of residence.

[ThomWV]

21. I believe that removing any requirements for complying with the home state requirements

When they say buy across state lines I take what they mean to be able to buy insurance that is not available in your own state for any reason, including that it might not meet your own state's minimum coverage requirements. Inf act that is what I thought this entire argument was about. That the mechanism that would be used to make it possible to buy across state lines would be that no sate could mandate what was covered by the foreign purchase, only that they had to accept it as coverage to satisfy the mandate for it.

[OneTenthofOnePercent]

22. It could be a federal stipulation...

Purchasing insurance from other state agencies is direct interstate commerce. If purchasing of policies out of state could turn out to be bad, it is ENTIRELY within congressional power to mandate that imported policies conform to the state the policy is acting within. This way, companies better structured to provide affordable insurance can provide to a wider market.

Capitalism WITH regulation is always a pretty good solution.

[ThomWV]

25. good point - good solution. nt

[CTyankee]

28. Ah, but then it is no longer capitalism. It is socialism.

That is the response from the Republicans. And they sure as hell don't want regulations from Washington! Reminds me of what Bush meant when he referred to "federal cufflinks"!!!:rofl:

[laughingliberal]

17. I do know that. One of the many reasons the exchanges need to be national & the anti-trust exemption

must be revoked. Both of those things must happen or the Senate provision allowing this must be removed.

[Johonny]

18. I don't know how true this is

The federal government controls trade between states, but states still have a say in what can be sold in their state. You can make your car anywhere in the US and try to sell it anywhere in the US. But to sell it in some states it must meet certain certified emission standards. I don't see how health insurance would be any different. As always the residence of the states with the worst standards and regulations will be the ones that suffer. But that's just like it always been for education, pollution, urban planning...

Now you can argue that progressive states like California are so targeted by conservatives because of this. California had nice progressive standards and a huge market. Thus there is a huge incentive to lower California standards because as California goes so goes the country. See the several hundred Texas school book standards threads to see the power of large market places to dominate other states with poor standards.

Of course the bottom is nothing at all. Which insurance companies are allowed to sell you now. Coverage that goes away once you need it. There are some good regulations in the current bill. The current bill will not necessarily help states with poor standards. But once again when the bill passes, having chosen this "fix" to health care Congress isn't done talking about it. There is going to be a need for constant retooling and fixing of regulations. Both at your state and federal level. Seems like more of an incentive than ever to vote for more progressives. If you want health care reform you better be in the fight for the looooooooong haul.

[hunter]

34. There's already plenty of fake health insurance... most of it in fact.

The kind that won't pay your medical bills or keep you out of bankruptcy once you cross their line.

With few exceptions, no matter how good you think your health insurance is, there is a point at which it will fail. Been there, done that.

Buying insurance across state lines will only bring that point of failure a little closer for everyone.

[NuttyFluffers]

35. of course. same reason different states have differing incorporation laws...

and note how almost all of the big, evil bank and insurance ones incorporate in Delaware, the state with the least regulation for corporations.

it's a means to sidestep ALL of the states power to defend its citizens from Corporate Predation, by allowing them to pit the bankrupt states against each other for the table scraps of Corporate $.

shock doctrine, people. not hard to figure out.