executive order will allow coverage to be sold across state lines

[werepossum]

Fortunately I'm only a few months away from Medicare coverage-unless the GOP takes that away aas well.

If this comes about it should be an interesting legal battle. Federal law is superior to state law. But federal regulations aren't law, they are interpretation and filling-out of existing federal statutes. From skimming the cited article this EO and the regulations it purports to create aren't based on any statute. The executive branch cannot create law by fiat, by declaring it so. Trump is not a royal king and has no such powers.

If this does come about, good individual health insurance policies will disappear. The vast majority will buy the $100 coverage instead of the $1,000 one-and will be none the wiser until they have a serious health claim. For decades the feds have left insurance regulation up to the states, for some very good reasons. If this goes through health insurance will be like credit cards-the state with the weakest laws and regulations will be home to all the insurers.

For a guy who seriously talked about adopting universal healthcare during the campaign, Trump's present course to wreck insurance coverage for us little people has me mystified.

Kinda like Obama's course wrecked insurance coverage for us little people. I pay more than ever, but if I have to have an expensive procedure, I now begin with "I have no health insurance; let's negotiate a price up front." Because I have to pay up front anyway and if providers have to deal with United Health Care, they charge me two to three times as much.

 

[werepossum]

What you're describing is literally the purpose of insurance. It's like asking why people should have to pay for fire insurance when their house isn't on fire. Like I've told you many times, if you want to cover people with pre-existing conditions in a free market way, this is how you do it. If you want a nationalized health care system that's fine by me, but the idea that an effective return to medical underwriting that cuts people off from health care is a better alternative to the present is ridiculous.

Meh, it's fine either way.

As for generating a single list of essential health benefits that was relevant to 300 million people the ACA did a fine job of it. Other countries do this in effect as well with their national health services by choosing what they cover. It's baffling that you would try and argue something is impossible when there are so, so many examples of it being done all over the world.

Actually it's like asking why people should have to pay for fire insurance when they have no house. Or more precisely, asking why people should be forced to buy the pool insurance rider when their house has no pool.

 

[Thebobo]

Actually it's like asking why people should have to pay for fire insurance when they have no house. Or more precisely, asking why people should be forced to buy the pool insurance rider when their house has no pool.

lol wha?

 

[fskimospy]

Actually it's like asking why people should have to pay for fire insurance when they have no house. Or more precisely, asking why people should be forced to buy the pool insurance rider when their house has no pool.

You're right, because if you don't have diabetes now that means you'll never have it in the future.

lolwut. The dumbness is overwhelming.

 

[sactoking]

Agreed, it’s either going to work or fail. I’d like to put this idea to rest either way

*What about States rights, how will compliance be handled?

Actually is not going to either work or fail; it already failed. Association plans were largely unregulated in the '80s and they were so terrible that Republicans had to lead a charge to subject them to state regulation, which is where we got the MEWA laws.

 

[glenn1]

What you're describing is literally the purpose of insurance. It's like asking why people should have to pay for fire insurance when their house isn't on fire. Like I've told you many times, if you want to cover people with pre-existing conditions in a free market way, this is how you do it. If you want a nationalized health care system that's fine by me, but the idea that an effective return to medical underwriting that cuts people off from health care is a better alternative to the present is ridiculous.

No, what you're doing is cross-subsidizing by mandating people buy insurance for risks they do not face and thus have no insurable interest in (such as your maternity insurance for males, etc). A similar example would be mandating that anyone who buys health insurance also buys boat insurance even if they don't own a boat in order to make boat insurance cheaper for people who do own boats. You are quite literally requiring them to buy something which they have no use for and literally could not use by definition. That's why health insurance plans should have low coverage requirements with people filling in their needs with specific niche products. The idea that "well that means no one who doesn't have diabetes will buy diabetes insurance thus it will be more expensive for those with diabetes" is exactly the unfair point this approach would begin to address. It might be a desirable social policy to "fix" the problem of "unfair" premiums for people with pre-existing conditions but the answer to that is to subsidize them transparently via taxes and spending and not hidden via forced cross-subsidy. Literally the only reason you didn't do it that way is because you know voters would probably reject increased taxes for it and thus you'd lose your precious policy goal.

 

[Jaskalas]

Guys, wtf are you making me get auto insurance for if I don't get into auto accidents? <-- Says guy with vehicle.

Now, I get it. Maybe you don't own a vehicle. But in this comparison are you trying to tell us you don't have health? You have no need for medical services? Sorry, but I'm calling BS.

 

[glenn1]

You're right, because if you don't have diabetes now that means you'll never have it in the future.

lolwut. The dumbness is overwhelming.

So then you support forcing people currently without houses to buy home insurance now under the theory "they may have one in the future"?

Guys, wtf are you making me get auto insurance for if I don't get into auto accidents?

You're mandated to get auto insurance to protect the financial interests of others for the liability you'll face if you hurt others in an accident, you are not required to buy it to protect your own financial interests. Unless you have a lien on your vehicle in which case you'll again be forced to have insurance to cover your financial losses on the vehicle which in turn could create potential losses to your bank; either way the coverage to protect you isn't mandated.

 

[fskimospy]

No, what you're doing is cross-subsidizing by mandating people buy insurance for risks they do not face and thus have no insurable interest in (such as your maternity insurance for males, etc). A similar example would be mandating that anyone who buys health insurance also buys boat insurance even if they don't own a boat in order to make boat insurance cheaper for people who do own boats. You are quite literally requiring them to buy something which they have no use for and literally could not use by definition. That's why health insurance plans should have low coverage requirements with people filling in their needs with specific niche products. The idea that "well that means no one who doesn't have diabetes will buy diabetes insurance thus it will be more expensive for those with diabetes" is exactly the unfair point this approach would begin to address.

This is ridiculous nonsense. Low requirements filled by 'niche products' means anyone who has one of those 'niche' illnesses that happens to be expensive is screwed. This is exactly what the association health plans will cause. Much better and smarter to do it the ACA way, which is to socialize health costs the same way we socialize all sorts of other insurance.

Also the idea that men have no interest in women giving birth to healthy children is comically myopic. Of course we do, which is why we all pay. Don't be silly!

It might be a desirable social policy to "fix" the problem of "unfair" premiums for people with pre-existing conditions but the answer to that is to subsidize them transparently via taxes and spending and not hidden via forced cross-subsidy. Literally the only reason you didn't do it that way is because you know voters would probably reject increased taxes for it and thus you'd lose your precious policy goal.

It's not hidden in any way, we're talking about it right now, in fact. I have no idea why you're so hung up on funding health expenditures through taxes, which everyone must pay, as opposed to health insurance, which everyone must have. It's the same thing.

 

[fskimospy]

So then you support forcing people currently without houses to buy home insurance now under the theory "they may have one in the future"?

As you get older, the odds of needing significant medical expenditures becomes a near certainty. Trying to equate an elective purchase with that is ridiculous nonsense.

You're mandated to get auto insurance to protect the financial interests of others for the liability you'll face if you hurt others in an accident, you are not required to buy it to protect your own financial interests. Unless you have a lien on your vehicle in which case you'll again be forced to have insurance to cover your financial losses on the vehicle which in turn could create potential losses to your bank; either way the coverage to protect you isn't mandated.

You're closer than you realize! If you lack the ability to pay for your health care the rest of society picks up the tab. Including everyone in an insurance pool regardless of what maladies they may pick up in the future is a great way to mitigate the liabilities an individual can place on society.

 

[glenn1]

This is ridiculous nonsense. Low requirements filled by 'niche products' means anyone who has one of those 'niche' illnesses that happens to be expensive is screwed. This is exactly what the association health plans will cause. Much better and smarter to do it the ACA way, which is to socialize health costs the same way we socialize all sorts of other insurance.

Also the idea that men have no interest in women giving birth to healthy children is comically myopic. Of course we do, which is why we all pay. Don't be silly!

I said men don't have an insurable interest in having maternity care for themselves. Their wives, mothers, etc. obviously have an insurable interest for their own health insurance policies. You are purposely conflating what you perceive as a social benefit to men being forced to cross-subsidize maternity care for women with the aforementioned risk transfer benefit a man could not possibly realize with mandated maternity coverage.

As for your ACA mandated benefits position, your argument comes down to "well you don't own a house now so you should get home insurance now to make it cheaper for those who own houses now. After all, once you own a house yourself the price for insuring it will go up!" Prices reflecting actual risks such as pre-existing conditions are exactly what true health insurance should be doing, what you're advocating for is "insurance" to cover an ever larger basket of pre-paid costs whether or not those costs are expected to be realized or ever could be. You're quite literally mandating people buy scam "volcano insurance" you know they can't use because it creates a pool of money you can transfer to some desired group of beneficiaries.

It's not hidden in any way, we're talking about it right now, in fact. I have no idea why you're so hung up on funding health expenditures through taxes, which everyone must pay, as opposed to health insurance, which everyone must have. It's the same thing.

Not really, because politicians know voters won't hold them accountable when the 'evil insurance company' raises rates to meet your social policy objectives whereas if they funded it via taxes they'd be out of office in a flash. If you're going to play Santa Claus and take from one set of people to give to another then I think you should be fully and completely judged on both the taking and giving, and right now you're doing it in a way designed to obscure that you're essentially the one doing the taking. Just because you subcontract the taking to an insurer doesn't mean it's not being done to meet your goals. I want that deception fully taken away and for you to own the cost shifting and the votes it might lose.

 

[fskimospy]

I said men don't have an insurable interest in having maternity care for themselves. Their wives, mothers, etc. obviously have an insurable interest for their own health insurance policies. You are purposely conflating what you perceive as a social benefit to men being forced to cross-subsidize maternity care for women with the aforementioned risk transfer benefit a man could not possibly realize with mandated maternity coverage.

As for your ACA mandated benefits position, your argument comes down to "well you don't own a house now so you should get home insurance now to make it cheaper for those who own houses now. After all, once you own a house yourself the price for insuring it will go up!" Prices reflecting actual risks such as pre-existing conditions are exactly what true health insurance should be doing, what you're advocating for is "insurance" to cover an ever larger basket of pre-paid costs whether or not those costs are expected to be realized or ever could be. You're quite literally mandating people buy scam "volcano insurance" you know they can't use because it creates a pool of money you can transfer to some desired group of beneficiaries.

Not this nonsense again. If you are for medical underwriting then just admit you don't want to cover people with pre-existing conditions and be done with it. Since I do, letting plans selectively drop care for expensive treatments is a nonstarter. I'm quite literally just making sure that if we're going to have a common risk pool that it works for everyone, otherwise subsetting risk pools defeats the whole purpose. This is just economics.

Not really, because politicians know voters won't hold them accountable when the 'evil insurance company' raises rates to meet your social policy objectives whereas if they funded it via taxes they'd be out of office in a flash. If you're going to play Santa Claus and take from one set of people to give to another then I think you should be fully and completely judged on both the taking and giving, and right now you're doing it in a way designed to obscure that you're essentially the one doing the taking. Just because you subcontract the taking to an insurer doesn't mean it's not being done to meet your goals. I want that deception fully taken away and for you to own the cost shifting and the votes it might lose.

The additional insurance costs that come from essential benefits are overwhelmingly picked up by the government and the funding for the ACA to make those payments was done through, you guessed it, taxes.

Why are you raging about this when you literally already got what you wanted?

 

[glenn1]

Not this nonsense again. If you are for medical underwriting then just admit you don't want to cover people with pre-existing conditions and be done with it.

No, I think the costs of their insurance premia should cover the costs they are expected to occur, e.g. medical underwriting. What YOU should just admit it that you don't want people with pre-existing conditions to have to pay the appropriate and underwriting-indicated premia to obtain that coverage. What you want isn't even insurance at all as the primary function of insurance to transfer measurable risks at an economically appropriate cost has been lost.

Since I do, letting plans selectively drop care for expensive treatments is a nonstarter. I'm quite literally just making sure that if we're going to have a common risk pool that it works for everyone, otherwise subsetting risk pools defeats the whole purpose. This is just economics.

No, it defeats YOUR purpose of cost cross-subsidization and enables the purpose of folks trying to get insurance coverage appropriate to their needs. The "ACA essential benefits" are grossly excessive and uneconomic for a large subset of the American population and a smaller cost/benefit plan would be much more suited to their needs. You want to prevent them from that because you're looking to harvest their wallets rather than looking out for their best interests.

The additional insurance costs that come from essential benefits are overwhelmingly picked up by the government and the funding for the ACA to make those payments was done through, you guessed it, taxes.

Why are you raging about this when you literally already got what you wanted?

Well then you should be agnostic as to the funding source and have no objection to changing it to direct taxpayer subsidies rather than unfunded mandate via superfluous "insurance" coverages. I would look forward to your support in advocating to our politicians that we do exactly that.

 

[Puffnstuff]

I want an executive order that forces fast food restaurants to serve cheeseburgers during all of their open hours. Don't tell me I have to buy breakfast because its not 11am yet.

 

[fskimospy]

No, I think the costs of their insurance premia should cover the costs they are expected to occur, e.g. medical underwriting. What YOU should just admit it that you don't want people with pre-existing conditions to have to pay the appropriate and underwriting-indicated premia to obtain that coverage. What you want isn't even insurance at all as the primary function of insurance to transfer measurable risks at an economically appropriate cost has been lost.

Of course what I want is insurance. You can't just make up definitions for something and then declare that everyone else needs to follow them. Insurance is a hedge against adverse future events. It has no requirement to conform with what you think is an 'economically appropriate cost'.

No, it defeats YOUR purpose of cost cross-subsidization and enables the purpose of folks trying to get insurance coverage appropriate to their needs. The "ACA essential benefits" are grossly excessive and uneconomic for a large subset of the American population and a smaller cost/benefit plan would be much more suited to their needs. You want to prevent them from that because you're looking to harvest their wallets rather than looking out for their best interests.

Oh good, we've gotten to the point at which you start ranting about my secret motives because you can't argue on the merits. Once you start subsetting benefits you render those with pre-existing conditions once again uninsurable through backdoor methods just like this change is trying to do. Therefore, it's a bad idea. If you think insuring people with pre-existing conditions isn't looking out for Americans' best interests then you'll have to take it up with Americans because they strongly disagree with you.

Well then you should be agnostic as to the funding source and have no objection to changing it to direct taxpayer subsidies rather than unfunded mandate via superfluous "insurance" coverages. I would look forward to your support in advocating to our politicians that we do exactly that.

I already said I was agnostic to the source and the current source works just fine. No need to change things just to make you happy because you don't like the accounting model.

 

[zinfamous]

That's part of the reason for doing this. It's unfair and stupid to force people to pay for "insurance" coverage they have no ability to utilize. A male has no insurable interest in maternity care for himself for example. People without diabetes shouldn't be forced under penalty of law to have a plan that covers it. The entire exercise of "essential health benefits" (like the diabetes example you just cited) is just an exercise in cost shifting anyway and you know it. If you want to shift costs then do it directly via subsidy from the Treasury rather than other policyholders. There is no possible way to generate a single list of "essential health benefits" that was equally relevant to 300+ million people.

There's a whole lot of wat? in this post but the bolded is the wattiest.

 

[brycejones]

There's a whole lot of wat? in this post but the bolded is the wattiest.

Everything Glenn1 posts eventually comes down to FYGM which is where the stupid comes from.