Skip to comments.Insurance Chief Suggests Adding A New, Lower Level Of Health Plan
Posted on 03/21/2014 4:03:45 PM PDT by Drango
Rather than letting people keep their old health plans that don't comply with the new requirements of the Affordable Care Act, the head of the group that represents the nation's health insurance companies is floating an alternative: weakening the requirements.
"If you take 10 categories of coverage," said Karen Ignagni, president and CEO of said in an interview taped for , "no matter how meritorious each and every one of those benefits may be ... you have a giant step up" from what many people had before, and wanted to pay for.
Those 10 categories make up the "Essential benefits" that nearly every plan now must cover in order to be considered compliant with the law.
Ignagni said forcing people to move from plans with lower premiums and fewer benefits to higher premiums and higher benefits was "a bridge too far for some individuals," and resulted in the decision by the Obama administration to allow people to for longer than the insurance industry would like. That's because insurers set their premiums for this year assuming those people would join the new risk pools. Allowed to keep their old plans, those presumably healthier people remain outside the new program.
As one possible alternative, Ignagni said she would create a "lower tier" of coverage.
"So that people could gradually get into the program; so they could be part of the risk pool," she said. "So we don't hold the healthier people outside; so the process could be working the way it was designed."
Currently, all four metal tiers of coverage must offer all the essential benefits, but with different levels of cost sharing. There is already a for those under 30 and certain others who can demonstrate financial hardship, but so far it hasn't proven particularly popular. According to the from the federal government, only 1 percent of those selecting a plan in the 36 states where the federal government is operating the exchange has chosen a catastrophic plan.
Ignagni's proposal would presumably fall somewhere between the catastrophic plan and the bronze level of coverage. And she insists it would not draw most people into the cheapest plans.
"We're not seeing that right now," she said. "I think by that hypothesis you would have expected an extraordinary amount of people to buy bronze, and they've chosen more silver."
Indeed, 67 percent of those in the federal marketplaces have chosen silver-level plans so far, but some have suggested that may be in part because silver-level plans have in addition to the premium subsidies that are available for all the metal tiers.
But would having a choice that offers fewer benefits help or hurt the existing market? That's hard to say, said , who helped develop the Massachusetts law that was the forerunner of the Affordable Care Act.
"It's a very, very tough question," Gruber tells Shots. "There's a tradeoff between premiums and benefits, and I don't think there's a right answer."
Much of the debate, he says, is simply philosophical, and comes down to a question of which benefits don't get offered: "Do we want to call something health insurance that doesn't cover prescription drugs?"
Actually they are not bad...I'm tired of playing for birth control for sluts...
I am not certain you can go any lower than the base level of coverage. It already pays for nothing.
The democrats want abortion, transgender change, pregnancy for men etc.... to be paid for in obamacare plus kickbacks from the healthcare industry.
” ... and resulted in the decision by the Obama administration to allow people to for longer than the insurance industry would like.”
I like to NPR, and, duh, on `All Things Considered’ today: garnishing unemployment checks for am-byoo-lance and ER gunshot wound treatment ... `Zinc level’ coverage.
Which we are already guaranteed by the Constitution.
Looks like the evil Insurance people realize that they are actually going to have to work for a living, just like the bad old days.
How about dropping the requirements the government thinks necessary and allow insurance companies and the market decide what to offer?
Besides having a huge deductible!
Now you know and half the battle is knowing.
When I was growing up in the ‘60-70s, my father, a union auto worker, didn’t have health-care insurance. Our family was covered under what was then known as “hospitalization.” It covered low-frequency, high-cost events like operations, broken bones, and babies. It did not cover routine visits to the doctor’s office, prescriptions, and the like. Such things were paid out-of-pocket and nobody expected nor demanded otherwise. Both the hospitalization premiums and out-of-pocket expenses were quite affordable. Health-care costs would plummet were we to return to such a system.
“Much of the debate, he says, is simply philosophical, and comes down to a question of which benefits don’t get offered: “Do we want to call something health insurance that doesn’t cover prescription drugs?””
Idiots. It’s none of their f****ng business.
Insurance companies participate in the “mandated” coverage schemes because mandated coverage amounts to non-compete clause by government fiat. A coverage that everyone MUST include is not a coverage they must compete greatly about.
As far as the question “Do we want to call something health insurance that doesn’t cover prescription drugs”: the “right” answer is up to the individual and depends on whether or not prescription drugs are or are not a major ongoing medical expense, a major ongoing or even just expected “annual medical expense” versus the annual cost of insuring that coverage. For a good many folks with no major medical problems, “prescription drugs” coverage for “possible” medical prescription needs might not be worth the expense.