Trump’s Plan for Health Insurance to Be Sold Across State Lines is Becoming Reality

While announcing the proposal of association health plans amongst small businesses, the Trump Administration is also aiming to facilitate health insurance policies across state lines. The rule will allow insurance companies to sell plans across state lines. The goal is to be able to provide plans and coverage that cost less.

Trump plans to allow insurance cpmanies to sell plans across state lines.
Trump plans to allow insurance cpmanies to sell plans across state lines.

Trump stated “I have private insurance companies coming and will sell private health care plans to people through associations. That’s going to be millions and millions of people. People have no idea how big that is. And by the way, and for that, we’ve ended across state lines. So we have competition.”

The issue that Trump is referring to is the state regulations that each state has. Each state differs in the requirements of what must be covered by insurance companies.

The association health plans would be considered under the federal law that allows large employers the freedom from state regulation. This way, these health plans can be sold across state lines.

Issues that lies with these plans are the fact that they can surpass the ACA’s requirement of providing the 10 essential benefits such as maternity care, mental health care, and emergency services to name a few. This allows the plans to offer fewer benefits, therefore costing much less. But the association plans cannot discriminate or overcharge individuals with pre-existing conditions.

These health plans can be structured across state lines, giving them the opportunity to market anywhere in the country. They may also set up to serve communities, or span several states. However, pricing is uncertain whether people in Manhattan will be priced the same as those in Texas.

“We are concerned that this could create or expand alternative, parallel markets for health coverage, which would lead to higher premiums for consumers, particularly those with pre-existing conditions,” according to a letter last month to state regulators, signed by America’s Health Insurance Plans and the Blue Cross Blue Shield Association. “Further, these actions destabilize the health insurance markets that guarantee access to comprehensive health coverage regardless of health status.”

Allowing this new rule will hopefully help Americans save money on health inurance.
Allowing this new rule will hopefully help Americans save money on health inurance, says Trump.

Pennsylvania’s acting insurance commissioner, Jessica Altman, voiced her opinion on the matter. “Generally speaking, these types of plans are exempt from state law and outside my jurisdiction,” Altman stated. “That means any issues that consumers have, I won’t be able to help them. More and more people would fall under the jurisdiction of the federal government, and I think state regulators would say we really do it better.”

The opportunity for health insurance plans to be sold across state lines will have an impact on the market. People will be able to purchase less comprehensive plans at a cheaper rate. But this can cause customers with extensive health issue or needs a hard time finding affordable plans. Healthier individuals will leave the marketplace for the skimpier non-regulated health plans, which will create a rise in premiums for those who need it- the sick.

Details on the rule must still be worked out by Congress and voted on, but if passed, it will change the health insurance market.

Healthcare Rates to Rise in 2019

In 2017 when President Trump did away with cost-sharing subsidies, it forced insurers to raise premiums. The cost-sharing subsidies helped pay back insurers for giving customers lower premiums due to their income status. Due to the halt in the subsidies, health insurance premiums have been rising. Mainly for those who have to buy their own insurance, approximately 34% in 2018 for silver plans. Insurers are now brainstorming what they will charge and if they want to participate in the ACA exchanges for 2019.

Insurers have been participating less and less in the market exchange, leaving customers with fewer choices. If more insurance companies decide to pull out of the exchanges, it will mean that customers will have even fewer choices available to them, at higher costs.

Health Insurance rates are increasing next year
Health Insurance premiums and deductibles are increasing next year

Premium Increase

Premiums will continue to keep growing without the cost-sharing subsidies to help with the costs impacted on insurers. The hike in premiums could be as much as 30% for 2019. It is projected that those that will be impacted the most are those who make too much money to qualify for premium support subsidies.

Eyles and Ceci Connolly, president and CEO of Alliance of Community Health Plans both voiced their disappointment of Congress failing to take action to fund cost-sharing subsidies.

“What’s happened is that several pieces of the puzzle have been pulled away. It is hard for me to isolate CSRs, what we are looking at now is a puzzle that is falling apart piece by piece,” Connolly said. “Losing the individual mandate, losing the cost sharing reduction subsidies and losing any hint of reinsurance, not to mention the risk corridors that were already gone, you’re just running out of options to manage the cost of this program.”

Funding

Midterm elections are approaching which brings up the issue of health care. While both political parties will be criticized, the polls have shown that voters hold Republicans more responsible for the high costs. Both parties have come to an agreement to include health insurance funding in the spending law. However, they could not agree on the details of what to fund exactly. Republicans are pushing for abortion restrictions stating insurers can cover abortions but cannot use federal funding for them, while Democrats do not agree.

If the bill receives funding, then hopefully it will offset costs, making it affordable.
If the bill receives funding, then hopefully it will offset costs, making it affordable.

Lawmakers are hoping the stabilization effort of adding funding to the bill will offset the costs of insurance. Health-policy experts disagree on how much it will help. Health experts state that the higher premiums will be offset for people by other subsidies they will be qualified for.

Republicans are not thrilled to stand behind the idea of the stabilization funding. They view it as saving the insurers of the health law, ACA, which they promised voters they would repeal. They blame the ACA’s regulations which stopped competition and drove up premium costs.  Congress is leaning towards unlikely passing the stabilization bill.

Insurers are expected to announce the premium price hike sometime in the fall.