Sun Sentinel Palm Beach Edition
Trump seeks insurance change
Proposal would allow health care insurers to market plans across state lines to increase competition on rates.
SACRAMENTO, Calif. — Allowing insurers to market health care policies across state lines is one of President Donald Trump’s main ideas for bringing down costs.
Critics say it’s unlikely to result in more affordable plans and could undermine stronger consumer protections in states such as California and Hawaii. Such a scenario could leave some older consumers with health problems unable to afford coverage.
Trump’s proposal appears unlikely to pass Congress unless Democrats cooperate. Congressional aides involved with health care legislation say the proposal to allow cross-state insurance sales would need 60 votes in the Senate.
In his speech to Congress on Tuesday night, Trump said the nation must turn to new ideas to help control costs.
“The time has come to give Americans the freedom to purchase health insurance across state lines,” the president said.
The estimated 20 million Americans who buy coverage directly from an insurer would be affected. Their health plans are regulated by state governments, which decide the minimum benefits that must be covered and mediate disputes between insurers and their customers, among other consumer protections.
Variation among the states was extreme until former President Barack Obama’s Affordable Care Act, which raised the minimum standards for legal coverage nationwide.
In New York, health plans had to cover everyone at the same price, whether sick or healthy, young or old. In California, patients must be able to see a primary care doctor within 10 days.
Trump and congressional leaders have vowed to repeal the law and replace it, although the details of their plans remain in flux.
The Trump proposal on cross-state sales would “eviscerate the ability of state legislatures and state governors to decide what the appropriate consumer protections are for their state’s consumers and businesses,” said Dave Jones, a Democrat who regulates some of California’s health plans as the elected insurance commissioner.
The concept of crossstate sales has been around for at least 10 years, but experts say there is a good reason why it hasn’t advanced: It might not deliver as promised.
“Premiums really reflect the cost of care where an individual lives,” said Barbara Klever of the American Academy of Actuaries.
Economist Joe Antos of the American Enterprise Institute said the idea of crossstate health insurance has an instinctive appeal because Americans have seen competition drive down costs in other areas, from credit cards to air travel. But Antos said it’s a “faulty analogy” when it comes to health insurance because where the competition really needs to happen is among hospitals and doctors.
Cross-state insurance is popular with conservative lawmakers who believe extensive state-level regulations require people to buy coverage they don’t want or need and drive up costs for consumers, particularly those who are young and healthy.