Interstate health insurance shopping

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John Goodman doesn’t seem like someone I’d normally agree with. I’m not talking about the former Roseanne star; I’m talking about the founder of the National Center for Policy Analysis. The site calls him the “Father of Health Savings Accounts” and  lists one of his major accomplishments as “playing the pivotal role in the defeat of the Clinton Administration’s plan to overhaul the U.S. health care system.”

That being said, I really enjoyed a posting he recently submitted to the HealthAffairs Blog on allowing consumers to purchase health insurance across state lines. He makes some great points about the benefits, including the ability to choose among 50 different insurance regulatory schemes. This means that if your state mandates in vitro fertilization coverage but not the chiropractic coverage you want, you could shop around for insurance from a state that does require chiropractic coverage to ensure you always have that coverage.

He notes that allowing interstate shopping could be bad for people with preexisting or chronic conditions. Healthy people from their state that might have normally subsidized their care through “guaranteed-issue and community rating in the individual market” might flock to states with cheaper insurance rates. This could leave people with preexisting or chronic conditions (which insurance companies do not like to insure) in ever smaller insurance pools and accordingly, higher premium costs. He mentions that the 6 states that currently require this could be exempt from interstate insurance shopping unless they want to opt in, but an even better solution would be “for states to find more rational ways of subsidizing the care of high-cost patients.” That’s the part that made me smile the most, because I fully agree that it’s important to help people with preexisting and chronic conditions receive affordable health insurance!!

Read the full posting here. If interstate health insurance shopping were allowed, what do you think states could do to subsidize the care of high-cost patients?

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