— by Vickie Rock
Have you noticed of late, that one Republican after another is proclaiming that “if only” we remove federal impediments and allow Insurance Companies to “sell insurance across state lines” costs for insurance will magically go down? UHHH, NO!
Let me be very clear here.
- There is NOT one U.S. federal law that prohibits health insurance policies from being sold across state lines. Insurance companies, should they choose to do so, can do that today.
- Doing so will NOT miraculously lower the cost of insurance. It will however, most likely increase the size and expense of Insurance company bureaucracies.
- Declaring that any insurance company can sell whatever policies they want in any state they want, technically stomps the crap out of States’ Rights, since State Insurance Commissioners regulate insurance policies sold in their states.
Two things come into play for insurance being sold today and everyday across state lines: rules established by State Insurance Commissioners and Networks established by Insurance Companies.
Let’s start with State Insurance Commissioners. They’re charged with protecting the rights of consumers and the public’s interest in dealing with the insurance industry and are responsible for regulating the insurance industry in their State. They review insurance policies proposed to be offered for purchase within the state to ensure compliance with Nevada insurance laws and regulations. They make sure insurance companies are solvent and have the ability to pay claims. And, when you’re unable to resolve a conflict as to coverage or billing with your Insurer, they’re the ones we turn to for help in resolving the issue.
None of those functions are performed by the Federal Government! Those are State functions and for Republicans to be putting forth arguments that are ludicrous and stomp the crap out of clear States’ responsibilities for their constituencies is pure hypocrisy on their parts.
Secondly, let’s talk about the insurance companies themselves.
For those of us who are familiar with employer insurance, we know that the line “if you like your insurance, you can keep your insurance” was pure bumpkiss at best. We’ve been hostage to whatever policies our HR department can obtain through negotiation with various insurance companies for our pool of employees. If our small pool has a number of catastrophic health events, our premium rates will be going up as well as our deductibles. We might also find ourselves in a restrictive network where any services provided by those outside of that network can be outrageously expensive.
Insurance companies establish relationships with various doctors, hospitals, labs, clinics, etc. and group them into “provider networks.” Urban areas have much larger and more inclusive networks service-wise, that do rural areas which frequently have mostly general or family practice physicians and fewer specialists like endocrinologists, gastroenterologists, oncologists, etc. Urban networks may include all hospitals in the urban area or may include just one, while rural areas may have no hospital and merely a local clinic.
Our rural town is lucky to have a rural hospital which may see some serious challenges under the GOP’s “American Health Care Act (AHCA)” given it will cut all support to “rural” hospitals. Some of the improvements we’ve seen of late with its ability to pull in “specialists” from our State’s urban centers might be in jeopardy. If your AHCA “network” should include only our local hospital, but the surgery or the treatment you need is not available locally as “in-network,” it’s going to cost you big time when you get charged for “out of network” care you seek from that urban center hospital up or down the road.
We have limited Insurance providers in Rural America because insurance companies don’t want to the bother of serving us. They don’t want to have to span across America and try to establish relationships with providers spread across vast areas and devise appropriate networks of providers. It’s more convenient for them to concentrate on the the competitive urban centers.
So NO, the GOP’s AHCA is not going to magically increase the number of policy options for those of us in Rural America as they claim. It does absolutely nothing to encourage “across state line” availability of insurance policies. AND, it does nothing to reduce the costs of either insurance policies or fees for services rendered. It may, however, actually make it worse for many of us who live in Rural America who are actively seeking medical services and/or insurance at costs we can actually afford.