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Its crazy that there are laws against offering health insurance in the open market. There is no reason you couldn't shop around for a plan just like you do for

Its crazy that there are laws against offering health insurance in the open market. There is no reason you couldn't shop around for a plan just like you do for car or home owners insurance.

boppo1 4y ago
Is that not what I do when comparing plans on healthcare.gov?
- mikeyouse 4y ago
  That’s exactly what it is except they have base “minimum essential coverage” laws that these ministries don’t abide by. “HCSMs are not regulated by the ACA. The coverage you get will vary from one HCSM to another, but they are not required to cover pre-existing conditions, cap out-of-pocket costs, or cover essential health benefits. And they can still have annual and lifetime benefit caps.” Since they’re not regulated entities, there’s no enforcement mechanism if you get sick and they decide not to pay out or delay your reimbursement.
- donatj 4y ago
  I mean kind of. There’s a ton of restrictions on who can have what plan where though, it’s not a very “free” free market.
- Spooky23 4y ago
  Sort of. ACA set ground rules for one segment of the market and did a good job doing so. There is a real competitive process in most states. Taking about free markets in the context of US health insurance in general is a waste of time.
- tomohawk 4y ago
  You cannot purchase plans across state lines. You cannot purchase the same plan you would get if you worked at a large company. The law is basically written by the insurers, and favors them. It allows them to segregate people based on who they work for, etc. In an ethical system, there would be just a single, non-segregated pool of people called a 'market', and anyone would be able to purchase any plan they want from that market, regardless of which state they lived in and regardless of who they did or did not work for. Federal employees have such a system, and prior to obamacare, there was actually bipartisan agreement forming around enabling everyone to participate in that system. It's probably why obamacare was rushed through quickly by the insurance companies.
  - amluto 4y ago
    The state line thing makes a degree of sense in the context of the (extremely broken) network system. Your insurer has a network of providers with whom they have negotiated rates. If you live far away from your plan’s intended market, you won’t be near the network, and everyone loses except the medical providers who get to overcharge you and your insurer as a result. It should be quite evident that everything about this system is broken, but this is part of how broken systems get entrenched.
    - ecommerceguy 4y ago
      I should remind everyone it is a republic and if you think state insurance commissions will let go of their fiefdoms I have some land in Florida I'll make you a great deal on. Kathleen Sebelius comes to mind!!
cfiggers 4y ago
Trust me, it's worth it. Most people have no idea the kind of unethical shit that HIPAA and then the ACA regulated out of existence—stuff that would make you say "How in the name of all that is holy was that legal until 1996???" One of the necessary casualties of that is restrictions on who is able to offer what and when. It's a good trade.
lr4444lr 4y ago
There has to be some kind of oversight. Otherwise, you get thousands of people victimized by fraud who the rest of us have to bail out.
- tomohawk 4y ago
  I can buy car insurance or pretty much any kind of insurance on the market, and there is suitable oversight. This does not exist for medical insurance. What I mean by that is if I work for a large company, I can get access to health insurance that I cannot buy on the market myself. If that company changes insurers to a crappy one, my only choice is to change employers to one that provides access to a better insurer. If I self employ, I cannot get access to those plans. Insurers should be forced to sell in a single market all the plans they offer. Insurer like to talk about "economy of scale" with large employers, but that is an artificial limit. Why should insurance pools be limited to who works at a company?
  - rqtwteye 4y ago
    “Insurers should be forced to sell in a single market all the plans they offer. Insurer like to talk about "economy of scale" with large employers, but that is an artificial limit. Why should insurance pools be limited to who works at a company?” Very true. There should be one insurance pool. Either state or nationwide.
    - ecommerceguy 4y ago
      There we're state pools until Obamacare wiped those away.
      - rqtwteye 4y ago
        Not really. A lot of people never were able to get insurance at all or lost it once they got sick. There should be one pool where everybody can get insurance regardless of agr, employment status or preconditions. Insurers should compete for that pool.
HWR_14 4y ago
Are there laws against offering health insurance in the open market? I'm pretty sure you could start up nonethewiser's insurance company and start taking enrollees. Or do you mean you'd have to sell them through a government portal? Or that you have to really offer a certain minimum level of care and coverage? And register with the state insurance commission? Because I'm pretty sure, except for the first one, that's a requirement for other insurances as well.

Its crazy that there are laws against offering health insurance in the open market. There is no reason you couldn't shop around for a plan just like you do for car or home owners insurance.

boppo1 4y ago

Is that not what I do when comparing plans on healthcare.gov?

mikeyouse 4y ago
That’s exactly what it is except they have base “minimum essential coverage” laws that these ministries don’t abide by. “HCSMs are not regulated by the ACA. The coverage you get will vary from one HCSM to another, but they are not required to cover pre-existing conditions, cap out-of-pocket costs, or cover essential health benefits. And they can still have annual and lifetime benefit caps.” Since they’re not regulated entities, there’s no enforcement mechanism if you get sick and they decide not to pay out or delay your reimbursement.
donatj 4y ago
I mean kind of. There’s a ton of restrictions on who can have what plan where though, it’s not a very “free” free market.
Spooky23 4y ago
Sort of. ACA set ground rules for one segment of the market and did a good job doing so. There is a real competitive process in most states. Taking about free markets in the context of US health insurance in general is a waste of time.
tomohawk 4y ago
You cannot purchase plans across state lines. You cannot purchase the same plan you would get if you worked at a large company. The law is basically written by the insurers, and favors them. It allows them to segregate people based on who they work for, etc. In an ethical system, there would be just a single, non-segregated pool of people called a 'market', and anyone would be able to purchase any plan they want from that market, regardless of which state they lived in and regardless of who they did or did not work for. Federal employees have such a system, and prior to obamacare, there was actually bipartisan agreement forming around enabling everyone to participate in that system. It's probably why obamacare was rushed through quickly by the insurance companies.
- amluto 4y ago
  The state line thing makes a degree of sense in the context of the (extremely broken) network system. Your insurer has a network of providers with whom they have negotiated rates. If you live far away from your plan’s intended market, you won’t be near the network, and everyone loses except the medical providers who get to overcharge you and your insurer as a result. It should be quite evident that everything about this system is broken, but this is part of how broken systems get entrenched.
  - ecommerceguy 4y ago
    I should remind everyone it is a republic and if you think state insurance commissions will let go of their fiefdoms I have some land in Florida I'll make you a great deal on. Kathleen Sebelius comes to mind!!

cfiggers 4y ago

Trust me, it's worth it. Most people have no idea the kind of unethical shit that HIPAA and then the ACA regulated out of existence—stuff that would make you say "How in the name of all that is holy was that legal until 1996???" One of the necessary casualties of that is restrictions on who is able to offer what and when. It's a good trade.

lr4444lr 4y ago

There has to be some kind of oversight. Otherwise, you get thousands of people victimized by fraud who the rest of us have to bail out.

tomohawk 4y ago
I can buy car insurance or pretty much any kind of insurance on the market, and there is suitable oversight. This does not exist for medical insurance. What I mean by that is if I work for a large company, I can get access to health insurance that I cannot buy on the market myself. If that company changes insurers to a crappy one, my only choice is to change employers to one that provides access to a better insurer. If I self employ, I cannot get access to those plans. Insurers should be forced to sell in a single market all the plans they offer. Insurer like to talk about "economy of scale" with large employers, but that is an artificial limit. Why should insurance pools be limited to who works at a company?
- rqtwteye 4y ago
  “Insurers should be forced to sell in a single market all the plans they offer. Insurer like to talk about "economy of scale" with large employers, but that is an artificial limit. Why should insurance pools be limited to who works at a company?” Very true. There should be one insurance pool. Either state or nationwide.
  - ecommerceguy 4y ago
    There we're state pools until Obamacare wiped those away.
    - rqtwteye 4y ago
      Not really. A lot of people never were able to get insurance at all or lost it once they got sick. There should be one pool where everybody can get insurance regardless of agr, employment status or preconditions. Insurers should compete for that pool.

HWR_14 4y ago

Are there laws against offering health insurance in the open market? I'm pretty sure you could start up nonethewiser's insurance company and start taking enrollees. Or do you mean you'd have to sell them through a government portal? Or that you have to really offer a certain minimum level of care and coverage? And register with the state insurance commission? Because I'm pretty sure, except for the first one, that's a requirement for other insurances as well.