How effective will this bill be with an opt out?

[mmonk]

From SFGate:

Some Democrats also were toying with a new plot to disarm GOP opposition: Allow individuals and states to opt out of a federal health care reform if they choose to.

"The president is working it," said Rep. Ron Kind, D-Wis., who said he was trying to get more cost savings in the 10-year, almost $1 trillion legislation. Back in his swing district, he said "the intensity is pretty great on both sides."

and

The opt-out could include not just individuals but entire states. Idaho's governor signed legislation Wednesday requiring the state to sue the federal government if it requires individuals to buy insurance, as the bill would. Similar legislation is pending in about three dozen states. ...


Gutierrez had said he could not support the Senate bill because it would ban illegal immigrants from using their own money to buy insurance on the exchange. But Wednesday he pointed to potential trade-offs that could help illegal immigrants in areas other than health care, such as housing.

Pelosi has insisted that deficit reduction remain a key goal even as Democrats craft a separate bill of "fixes" to the underlying Senate legislation that would increase its cost by increasing subsidies for people to buy insurance, reducing the "Cadillac tax" on high-cost plans, boosting payments to states for expanding Medicaid, and closing a coverage gap in Medicare's prescription drug benefit.

Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/03/17/MN0N1CHB52.DTL#ixzz0iX0x56wC

[zipplewrath]

1. There already is

If you fall into certain "holes" between income, subsidy, and availability, you can be exempt from having to purchase insurance. Which means of course the the sickest of meager means will be without health insurance.

[mmonk]

2. But states opting out will defeat the purpose of the bill.

Well, to tell you the truth, I don't know the purpose of the bill anymore.

[zipplewrath]

3. My first thought

I don't know the real purpose. And I don't know what these states will be opting out of. Will the insurance companies be exempt from denying coverage for pre-existing conditions?

[mmonk]

4. It would seem so unless they make a provision the insurance

lords can't exploit in the courts.