Major insurance groups call part of health bill 'unworkable'

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"Policy solutions exist to create more stability in the market by reducing premiums and attracting enrollment of younger and healthier individuals", AHIP said.

Her message seemed to have been lost on the senator, who said Obamacare is in a death spiral and that Republicans were elected to rip it out "root and branch".

Also, the Senate bill would shrink the program even more over time by pegging the annual growth rate of those funds to standard inflation, rather than the more generous medical inflation, starting in 2025. Ted Cruz (R-Texas), would allow insurers to resume sales of policies that leave out key benefits, such as prescription drugs or mental health. In order to secure Lee's and Cruz's votes for the bill, Senate Majority Leader Mitch McConnell may have to include their amendment but find a way to satisfy moderates by minimizing the measure's destabilizing effect on insurance markets.

The amendment, crafted by Sen.

Notably, the insurance industry itself seems to believe splitting the market this way could be a terrible, infeasible idea. Matheson falls into the infamous "doughnut hole".

"Imagine if vehicle insurance companies were required to charge everyone the same auto insurance rate regardless of how likely they were to get into an accident", Lee, a Utah Republican said Wednesday night, The Salt Lake City Tribune reports. Insurers could offer plans with reduced benefits, no maternity coverage, for example.

"Those of you who are older and perhaps have good driving records - no tickets, no accidents - would be forced to pay higher insurance premiums".


The problem with the Cruz amendment is that it would allow healthy people to pick the cheapest plans and cause the price of coverage to skyrocket for those who need more comprehensive coverage. In general, a fixed-indemnity insurance plan does not conform to the Affordable Care Act (ACA or "Obamacare"), because it doesn't provide the minimum essential coverage required by the ACA.

Driving the healthiest people out of the risk pool - and the sickest people into it - is a surefire way to send costs soaring. Most of the people insured by these pools received subsidies, paid for by premium taxes imposed on insurance companies.

"It is unworkable in any form and would undermine protections for those with significant medical conditions, increase premiums and could lead to widespread loss of coverage for people now enrolled in the individual market", wrote the main industry trade group, America's Health Insurance Plans, and the Blue Cross Blue Shield Association.

The Henry J. Kaiser Family Foundation, a nonpartisan health care think tank, projected that 1.5 million Americans with pre-existing conditions would face higher premiums under Lee's proposal.

That might not sound like much, but it has the potential to drive down premiums and re-shape individual health insurance markets across the country, which right now are collapsing under the weight of Obamacare regulations and rising premiums. Eighty-five percent of Utahns on the exchange receive those subsidies. Health insurers would also be forced to apply two totally different models to the same risk pool, which some say would be incredibly hard and costly to accomplish. The results are similar across the state and across income levels. Mike Lee said during an online town hall meeting.

"People don't really get health insurance", she said.

If the latest effort fails, maybe Lee and the other senators will listen to constituents like Bivin and Matheson - and thousands more like them - and turn their attention to fixing the flaws in Obamacare instead of pursuing a path that puts meaningful health care out of reach for millions.

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