One response to my note was that it was already in the bill while yours says something different. I'm not sure I understand your response - almost all products are sold across state lines (automobiles, food, drugs, software, etc.) and many products are regulated.
Hmm, I assumed this was already known. I should make myself clearer. The Rep proposal to sell health insurance across state lines is already in the Senate bill (not certain about the House, but there's little doubt it will be in the proposal the WH favors). However, best I can tell, the Reps simply want to have the legal provision permitting such.
The drawback to that is that it would creates powerful race-to-the-bottom incentives. The state with the weakest regulatory policy will become the home to every savvy health insurance company in the country (and the fees attendant). Thus, the fairly weak regulations that now exist at the state level will be effectively ended.
The second drawback is that it "incentivizes" (terrible word but it appears to be par for the course these days) cherry picking by insurance companies. Sell policies only to the healthy who will, for the large bulk of policy holders, not use the insurance. Then some other public body is left to create so-called "high risk" pools for the difficult to insure. The rates for those folk (who will, eventually, be all of us as we age) sky rocket.
The answer the Dems have to these two drawbacks are the exchanges which would be regulated at the federal level. And this regulation is what bothers the Reps.
As for your comment about individual mandates as the answer to folks who game a system that prohibits discrimination on the basis of a pre existing condition, that this would not survive a court challenge. The basic answer is that the government mandates all sorts of things all the time. Definitely not a problem.
Paying taxes is a mandate. Just try not paying them; wait around a few years until the IRS catches up with you; bang. Government, at a variety of levels--local, state, and federal--mandates fees of all sorts of types.
Definitely not a problem. |
