Trump thickens insurance plot
Regulators, companies wonder about details of cross-state markets.
President Donald Trump’s announced plans to sign an executive order making it easier for consumers to buy health policies across state lines sent ripples through the country Thursday, and an official with Florida’s biggest insurer took stock in West Palm Beach.
“We believe states are going to have a far bigger issue than insurance companies when it comes to this concept of selling across state lines, as each individual state has its own insurance commission that has a job to protect its own consumers,” said Gordon F. Bailey III, vice president of public affairs and community engagement for Jacksonville-based Florida Blue.
Companies will live by whatever rules are set, he said.
Bailey talked about what comes next for health care as the featured speaker at Palm Beach County’s Business Development Board annual luncheon.
“I’ll probably be signing a very major executive order where people can go out, cross state lines, do lots of things and buy their own health care,” Trump told reporters Wednesday. “It’s being finished now. It’s going to cover a lot of territory and a lot of people, millions of people.”
The national advocacy group Consumers Union has warned selling across state lines could foster “junk insurance” and a “race to the bottom” for insurers to cluster in the states with the weakest consumer protections. In turn, it could undercut the ability of individual states to set their own rules to protect, say, consumers with prior health problems from being denied coverage or charged more, the group said.
Senate Republicans concluded this week they could not find the votes to pass an overhaul of Obamacare.
Florida’s Department of Financial Services “will continue to look deeper at the concept of inter-state insurance sales — and its possible impacts on Florida’s policyholders — as the specifics of President Trump’s plan come to light,” said spokeswoman Ashley Carr. “Florida has fashioned itself a leader in implementing insurance consumer protections, and we’d look to see that those protections remain in place.”
Florida’s Office of Insurance Regulation said it will “look forward to reviewing the executive order once it is signed.”
Trump touted selling across state lines on the campaign trail last year. Proponents including Kentucky Republican Sen. Rand Paul say it potentially gives consumers more marketplace choices, promotes competition and could lower costs.
Paul, who opposed the latest GOP Senate bid to rewrite the Affordable Care Act as “fake repeal,” said he wants real repeal and in the meantime has been working with Trump for six months on an order that would let individuals join associations and buy policies across state lines.
The idea is millions could get “get cheaper prices and a better product,” Paul said. He said he expects the president to sign the order in the next couple of weeks.
But others say how any order is worded is very important.
“We haven’t yet seen the details of any proposed executive order and can’t comment until we see the specifics,” said Mike Consedine, CEO of the National Association of Insurance Commissioners. “As a general matter, health insurers already have the ability to sell insurance in multiple states as long as they comply with state consumer protection and licensing laws, which many already do. The NAIC has long been opposed to any attempt to reduce or preempt state authority or weaken consumer protections.”
Insurers have a limited ability to sell across state lines under current law and waivers to the Affordable Care Act, though as a practical matter it rarely happens because provider networks are usually set up on a state-bystate basis.