Some States are taking steps to “develop” lower cost health plans that will help lower costs and improve access. But, they face opposition!

In previous Post, we discussed President Trump’s Exec Order allowing health plans to be created that would lower cost with benefits people really want but not be compliant with the ACA. A few states are moving in that direction. The plan development from these states is just getting started, for sure, but already there are promises from pro-ACA advocates to sue any State or Insurer that implements such plans.

We’ve seen litigious threats and real lawsuits, in other efforts to bring common sense ideas back to life. Limiting “immigration” or “visa” permits from certain countries, increasing border security, and even lowering taxes have all come under siege and litigation by the left. The Left continually tries to thwart  President Trump’s  efforts to improve the economy, increase jobs available, improve security, and well, Make America Great Again.

So, why should we be surprised that the pro-ACA advocates would threaten lawsuits against states when the State’s leadership is trying to increase health plan alternatives, lower cost and improve access to providers.

The good news should be reported that the various state leaders out in front in these attempts to improve healthcare delivery and finance are doing so with the right ideas and ideals in mind.

These state leaders are seeking plans and ideas that:

  • Include complete transparency. Transparency where the consumer could see the actual cost of treatment. Patients and their Doctors should be able consider the effectiveness as well as the cost to benefit of any treatment.
  • Change the treatment practice of ordering multiple tests to avoid potential liability. Treatment should focus on healing the patient not avoiding lawsuits.
  • Create a free market environment that allows providers and pharma to make a profit but avoid the outrageous pricing scenarios we see today.
  • Allow small employers to “partner” with insurers. This means allow employers to purchase coverage for catastrophic events and self insure the healthcare under a certain value, for example $10,000. This can be done using currently available HRAs.
  • Allow for employers to “incentivize” their employees to make better choices. Today employers fear being sued if they encourage their folks to stop smoking or lose 20 lbs. with a health plan that gets richer as the employee gets healthier.
  • We must stop federal government interference in the local marketplace. The rules and restrictions of the ACA are driving up the costs and the one-size-fits-all policies just don’t work.
    * For employers in some states, such as California, we might need some Federal assistance in the form of ERISA.
  •  Most agree that it is important to develop ways to help insurers provide coverage to the individuals who are driving the majority of the costs.
    * Let’s face it, the statistics prove that less than 5% of any group will incur more than $5000 (or even $10,000) in medical charges each year.
    * But, in that 5% of the population, the medical charges can be huge, catastrophic as they say, and there is little the citizen-patient can do about the cost of his/her treatment. So, insurers honestly need assistance to finance these charges.

The point is that we are watching state regulators look at realistic ways to improve access and lower cost without penalizing our citizens for their healthcare usage.

Remember this fact, the enrollment in ACA individual plans at the close of this year’s open enrollment is only about 8 million enrollees. The plans we’re discussing above could be considered as alternatives by 50 to 100 million employees currently in small group plans around the country.

But, these new ideas will be criticized and litigated simply because they conflict with and/or weaken the ACA. If 50 million of our fellow citizens could get access to enroll in these lower cost plans, would that not be a good deal. We might make America’s healthcare great again. Sorry for that.

Anyway, we should be glad that there are creative people developing ideas and even real plans that will increase access to more providers, provide the benefits people really want, and lower cost in both premium and out of pocket. As we said in previous Posts, you won’t see or hear much about it in the Media so we’ll have to watch for it ourselves.

But then, we’re all in this together, so let’s keep watching together.
Let me know what you think.

Until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf

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