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Cruz Proposal Reminds State Insurance Regulators of 'Junk Insurance — NYTimes

17 July 2017, 04:02 | Terri Saunders

The Congressional Budget Office will soon receive a pair of amended versions of the Senate's Better Care Reconciliation Act, one of which has been crafted by conservatives Ted Cruz of Texas and Mike Lee of Utah.

One of the critical parts of the ACA was that it prohibits insurers from denying coverage to or charging more for people with pre-existing conditions. Under Obamacare, all those people with preexisting conditions, who previously had been in high-risk pools, were lumped into individual insurance markets with everybody else, which of course caused premiums to rise.

And in a related scenario, people who are priced out the market because of a pre-existing medical condition, who turn to a health plan with minimal coverage, can find themselves unexpectedly facing very high bills. To qualify, insurers would just have to offer one plan that complies with the ACA's comprehensive benefits standard. It would allow insurers serving the individual market and accepting customers who purchase insurance with the help of federal subsidies to offer policies that do not conform with the coverage mandates enshrined in the ACA. It is simply unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people now enrolled in the individual market.

But there is a glaring flaw in this idea - one that the CBO itself as well as Congress' own Joint Committee on Taxation has pointed out: low-priced insurance plans that offer only limited protection from medical and/or financial disaster won't be counted as actual insurance when legislation is given a budget score.

"Unfortunately, this proposal would fracture and segment insurance markets into separate risk pools (for the healthy and unhealthy) and create an un-level playing field that would lead to widespread adverse selection and unstable health insurance markets", the organization said in a memo it released Wednesday.

The CBO estimated the original bill would increase the number of uninsured Americans by 22 million by the end of 2026.

A proposal to let Obamacare insurers sell skimpier coverage will be the wildcard in efforts to pass the revised Republican health care bill that's expected to be unveiled on Thursday.

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The Cruz amendment would go an extra step, potentially prodding millions of people with problems like diabetes or heart conditions to stay insured.

But Holtz-Eakin was more positive about the latest iteration of the Senate GOP legislation, which provides an additional $72 billion that states could use to stabilize their individual marketplaces.

At the time, the system favored young, healthy people who wanted to buy cheaper plans without all the frills.

Elizabeth Imholz, a health policy expert for Consumers Union, said the plan will leave consumers with "huge, unexpected out-of-pocket costs".

Prior to choosing a fixed-indemnity insurance plan, it's important you understand what such a health plan entails.

Whether that funding would be enough to make the plans affordable remains to be seen. "If the cost of premiums continues to skyrocket, as they have under the last seven years under Obamacare, than we will have failed".



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