House GOP health care proposal makes no mention of interstate insurance policies
In his address to the joint session of Congress last month, Trump told lawmakers it was time to allow Americans to buy health insurance across state lines.
“The time has come to give Americans the freedom to purchase health insurance across state lines – creating a truly competitive national marketplace that will bring cost way down and provide far better care,” Trump said.
But there is no mention in the proposals, announced by Republican members of two House committees, of allowing insurers to sell across state lines.
In a tweet to the Fox News Channel's morning show hosts, Trump tweeted Tuesday, "Don't worry, getting rid of state lines, which will promote competition, will be in phase 2 & 3 of healthcare rollout. @foxandfriends."
That is not necessarily going to be a major issue, according to Seth Chandler, a visiting fellow at George Mason University’s Mercatus Center. The law professor at the University of Houston said that provision was never going to be a miracle cure to bring costs down in the individual marketplace.
Chandler told Patient Daily he believes there is no regulatory impediment to insurers selling across state lines, and it may bring some benefits particularly where the state has very tough regulations that drive up plan prices. He noted it is often not profitable for insurers selling state-based plans to move into another state, and they will not have networks set up to facilitate such transactions.
Drafts of two bills from separate House committees were announced Monday evening. House Republicans want to replace subsidies with tax credits, curb funding for Medicaid, and scrap the individual mandate. To encourage individuals to maintain health coverage, the bills permit insurers to impose a surcharge of 30 percent for those who have a gap between health plans.
Crucially, the proposal would keep the pre-existing clauses of the ACA, and allow younger people to stay on their parents’ health insurance policy until age 26.
Marrying the pre-existing clause -- where patients can not be denied coverage for a previous illness -- and giving insurers more freedom to develop their plans is going to be the major challenge, Chandler said.
“Both of those goals seem great when viewed separately. The unbelievably complicated problem, though, is that it’s extremely difficult to meet both goals at the same time,” he said.
Four Republican senators said they they would oppose any new plan that would potentially leave many without any coverage. All the senators are from states that expanded Medicaid.
“We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states,” Sens. Rob Portman (R-OH), Shelley Moore Capito (R-WV), Cory Gardner (R-CO) and Lisa Murkowski (R-AK) wrote in a letter to Senate Majority Leader Mitch McConnell (R-KY).
Chandler said the president, in his address to Congress, identified drug prices as being a major cost driver. Lowering drug prices will help tackle the problems in the health insurance market, but it must be done in an intelligent way, he added.
Similar to interstate health plan purchases, the issue of drug prices was not addressed in the latest proposals from House Republicans. These, too, are likely to be dealt with separately.
Trump tweeted on Tuesday, "I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!"
The debate over the House Republican proposals is likely to begin in committee as early as Wednesday.