What If No One Sells In an Obamacare Marketplace?

Sarah Kliff: “There are at least three states that currently have just one health insurer planning to sell on their Obamacare marketplace in 2017: Alaska, Alabama, and Wyoming.”

“The health care law doesn’t have a backup plan if any of those states have their sole carriers drop out… A federal official told the Wall Street Journal he was “pretty confident” there would be no areas with zero carriers β€” but he also couldn’t rule out the possibility.”

“An Obamacare market with no sellers would leave thousands of enrollees unable to use tax subsidies to buy insurance coverage. And the government doesn’t have any particular legal power to cajole carriers into setting up shop in the markets they find undesirable. The most they can do, it turns out, is ask really nicely.”

37 Comments

  1. THIS is why this nefarious agreement with private health insurance was poison. Why does no one call out the 800 lb gorilla? The “free market” has no business as middle man between patient and doctor!

    Public option, or “medicaid for all”. Screw these money-grubbing insurance monsters.

    1. If people want single payer in health care; why not a single payer for food, water, clothing, housing, electricity, gas, auto insurance, life insurance, internet and cell service?

      1. If people want free market, why not free market for police, fire, roads, and defense?

        1. Police, fire and most roads are locally funded not federally. Defense is in the Constitution as a federal issue.

          1. If you want universal care: Those who can afford health insurance buy it if they wish. Those that need help (at or near poverty level), paid into Medicare or it is a military benefit get financial assistance to buy health insurance. 100% coverage.

          2. You want Medicare to be massively expanded to cover all Americans at or near the poverty line, regardless of age?

            Communist. πŸ˜‰

            If people who think they’re immortal (namely young people) opt not to buy health insurance, than many Americans who are not technically poor won’t be able to afford it–particularly those with pre-existing conditions, with sick children, etc. The way insurance works, private or public, is that healthy people pay into the system, knowing that nobody stays healthy forever.

            It can’t work if people say “I’ll get insurance if I ever get sick.”

            Even healthy people need preventative healthcare to stay healthy, which also costs money. Putting it off leads to much higher bills later.

            Obamacare isn’t failing–the state governments that refused to accept it are.

          3. Maybe you did not comprehend what I posted.

            Medicare is government run health insurance. I am saying abolish Medicare and replace it with financial assistance so they can buy their own health insurance of their own choosing, but only for those who truly need the assistance. Those that can afford to buy their own health insurance can buy their own health insurance.

            In other words, a real safety net for those that are disabled and are at or near the poverty line. Not a government run program for everyone.

          4. Maybe you aren’t very good at expressing your ideas, or in thinking them out?

            Financial assistance means that people will never have enough to pay for healthcare. It also means government money, so what’s your point? You don’t have one. You are just jerking the knee.

            A safety net is not only something that people with disabilities or are poor need. Everybody who isn’t truly rich–which is nearly everybody–can become horribly ill or injured at a moment’s notice. You think that won’t happen to you? What a damn fool you are.

            I have insurance from my job. That’s not down to anything special I’ve done. Other people who work as hard or harder than me don’t have good insurance, or any insurance. Explain to me why they have to live in constant fear of illness or injury, to themselves or loved ones.

          5. SNAP is financial assistance for food. Does that mean it does not work?

            Get government out of the health insurance business as much as possible. Limit them to limited regulations and financial support for health insurance to those who need it.

            Government is about half the health insurance market with Medicare, Medicaid and the VA. This is why the health insurance market is not functioning like a normal market in any other industry.

            Obamacare, Medicaid, Medicare and VA hospitals should be phased out. People under these programs and those who are financially below the poverty level should be given a yearly amount that they could use to purchase health insurance.

            Keep the federal regulation stating that insurance companies have to cover pre-existing conditions as long as the person had previous insurance.
            Allow people to purchase insurance from any state. Deregulate state health insurance markets. Unhinge medical insurance from employers in the tax code.

            Getting government out and increasing competition in this way will lower health insurance costs. It cuts the bureaucracy costs, cuts the fraud costs and improves competition and quality of care.

            Why not do financial assistance for health insurance the same way we do financial assistance for food?

          6. Because healthcare costs more than food, and people are more likely to put off getting care they need than eating.

            I’m fine with ‘as much as possible’–we just don’t agree what that is. We’re all hurt as a society by huge numbers not having access to healthcare. And when people get desperate enough, they go to emergency rooms, and the bills are far higher, and they can’t pay them. Guess who does?

            Everybody on Medicare prefers Medicare–including most conservatives. Veterans have had a lot of problems with the VA–they still use it–makes their lives a lot easier–you want to tell them that’s over, go ahead. Obamacare needs to be expanded, not phased out.

            Insurance companies won’t agree to getting rid of pre-existing conditions, without getting a lot more customers into the bargain. Republicans will promise to do this, but guess what? The insurerers will lobby them and they’ll cave. None of their promises will be worth a damn.

            Why not do financial assistance the way we do food stamps? Because it’s dumb. Even somebody on minimum wage can afford to eat–because we go to some pains as a society to make sure certain basic food staples don’t get too expensive. You want to tell me how we do that with a heart transplant or chemotherapy?

            You could have saved yourself a lot of typing by just saying “Let them die in the street.” Trump may not know much, but he knows this–that’s exactly what Cruz was saying at that debate–and he wasn’t trying very hard to deny it either.

          7. Food is about $200 per person per month. Health insurance is about $200 – $300 per person per month. There is not that big of a difference.

            In an emergency people would go to the nearest hospital but because prices had been driven down by the health insurance market, the cost of the emergency care would reflect that in their health insurance premiums, no shopping around in an emergency needed.

            “States could use a variety of approaches to provide coverage to individuals who are unable to purchase insurance. For instance, 35 states already operate high-risk pools with a collective current enrollment of 227,000 individuals to ensure access to coverage for individuals with pre-existing conditions.[17] Alternatively, states could establish reinsurance or risk transfer mechanisms under which insurance companies would reimburse each other for the cost of treating individuals with high medical expenses without added funding from state or federal taxpayers. Either approach would be far preferable to the massive amounts of regulation, taxation, and government spending under Obamacare.”

            http://www.heritage.org/research/reports/2013/10/after-repeal-of-obamacare-moving-to-patient-centered-market-based-health-care

          8. Okay, now I really am going to have to conclude you are either deeply dishonest or a simpleton. Which is it?

            You always need about the same amount of food.

            The amount of healthcare you need can go from absolutely none to hundreds of thousands of dollars worth in an eyeblink. The nearest hospital could never possibly absorb the costs unaided. Prices would not be driven down that far, or at all. You are just whistling dixie here. “The miracle of the free market.” Bull. SHIT.

            States could use a wide variety of approaches, sure–that’s the problem. It was a problem during the Jim Crow era too. The right to decent healthcare is no less important than the right to vote, or get a decent education.

          9. Looks like you have a serious comprehension problem. The discussion is about health insurance not the cost of individual procedures that would be covered by that health insurance.

            Someday you will wake up from your nonsense.

          10. Okay, now I really am going to have to conclude you are either deeply dishonest or a simpleton. Which is it?

            You always need about the same amount of food.

            The amount of healthcare you need can go from absolutely none to hundreds of thousands of dollars worth in an eyeblink. The nearest hospital could never possibly absorb the costs unaided. Prices would not be driven down that far, or at all. You are just whistling dixie here. “The miracle of the free market.” Bull. SHIT.

            States could use a wide variety of approaches, sure–that’s the problem. It was a problem during the Jim Crow era too. The right to decent healthcare is no less important than the right to vote, or get a decent education.

          11. Your ideas about “free market” healthcare have never worked, EVER. There are zero examples of any modern nation having a successful fully private healthcare system.

            That being said – I agree that employer based health insurance is stupid and should go away.

            A German model is probably the best approach for the US

          12. You want Medicare to be massively expanded to cover all Americans at or near the poverty line, regardless of age?

            Communist. πŸ˜‰

            If people who think they’re immortal (namely young people) opt not to buy health insurance, than many Americans who are not technically poor won’t be able to afford it–particularly those with pre-existing conditions, with sick children, etc. The way insurance works, private or public, is that healthy people pay into the system, knowing that nobody stays healthy forever.

            It can’t work if people say “I’ll get insurance if I ever get sick.”

            Even healthy people need preventative healthcare to stay healthy, which also costs money. Putting it off leads to much higher bills later.

            Obamacare isn’t failing–the state governments that refused to accept it are.

          13. Well you only need to read about the civil rights era to know that.

            All Americans deserve the same access to healthcare. We can do it on a regional basis, sure–Canada does. But all Canadians know they can get sick or injured without going bankrupt. That’s the goal here, and you have no helpful suggestions how to achieve it. You want total self-sufficiency for all–until it’s you. Then you scream to the high heavens for help. Disgusting.

          14. Well you only need to read about the civil rights era to know that.

            All Americans deserve the same access to healthcare. We can do it on a regional basis, sure–Canada does. But all Canadians know they can get sick or injured without going bankrupt. That’s the goal here, and you have no helpful suggestions how to achieve it. You want total self-sufficiency for all–until it’s you. Then you scream to the high heavens for help. Disgusting.

    2. You do realize that Medicare also works with private insurers, right? And Medicaid for all was never remotely an option.

      We do need to fix this, and public option is probably the best way. But getting private insurers out of the picture entirely–that’s not going to happen.

      1. Medicare Advantage plans now cover one-third of all Medicare beneficiaries. In many urban areas, the number is more like 50%. Medicare is being “privatized” through Medicare Advantage and insurance companies are happy to participate. That’s because they are guaranteed to make money through “risk adjustments” where they get paid more money from Medicare for their enrollees who are sicker and costlier.
        Obamacare built in something similar to “risk adjustment” in order to protect health insurance companies from financial losses in the first three years of the program. But Republicans have stopped the “risk corridor” payments and screwed the insurance companies big time. Republicans are fine with protecting (and overcompensating) insurance companies so they can move Medicare into the hands of for-profit insurance companies – but they have blocked risk corridor payments so they can kill Obamacare.

        And their tactics are going to leave thousands of people in Arizona with no health insurance options: http://medicareblog.org/end-health-insurance-az/

    3. You do realize that Medicare also works with private insurers, right? And Medicaid for all was never remotely an option.

      We do need to fix this, and public option is probably the best way. But getting private insurers out of the picture entirely–that’s not going to happen.

  2. A friend of mine lives in a county in Texas where this is already the case- United Healthcare’s pullout left his county with no options on the exchange. If BCBS does likewise, I’ll be in the same position.

  3. Get government out of the health insurance business as much as possible. Limit them to limited regulations and financial support for health insurance to those who need it.

    Government is about half the health insurance market with Medicare, Medicaid and the VA. This is why the health insurance market is not functioning like a normal market in any other industry.

    Obamacare, Medicaid, Medicare and VA hospitals should be phased out. People under these programs and those who are financially below the poverty level should be given a yearly amount that they could use to purchase health insurance.

    Keep the federal regulation stating that insurance companies have to cover pre-existing conditions as long as the person had previous insurance.

    Allow people to purchase insurance from any state. Deregulate state health insurance markets. Unhinge medical insurance from employers in the tax code.

    Getting government out and increasing competition in this way will lower health insurance costs. It cuts the bureaucracy costs, cuts the fraud costs and improves competition and quality of care.

    Why not do financial assistance for health insurance the same way we do financial assistance for food?

    1. Talk about death panels.

      Most of the developed world doesn’t do it the way you suggest. Why do you think that is?

      1. So if the rest of world does not do it the best way we should follow their lead and use a substandard method?

        1. That’s what we WERE doing. And the rest of the world was laughing at us. Now it’s just laughing at you. πŸ˜€

        2. That’s what we WERE doing. And the rest of the world was laughing at us. Now it’s just laughing at you. πŸ˜€

    2. Talk about death panels.

      Most of the developed world doesn’t do it the way you suggest. Why do you think that is?

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