2aguy
Diamond Member
- Jul 19, 2014
- 111,952
- 52,201
- 2,290
Here is the new idea from Trump to make healthcare portable from one job to another, and it also addresses pre-existing conditions....
Trump Administration Gets Smart On Pre-Existing Conditions
As I first explained when the administration proposed this HRA rule back in October, much of the problem surrounding pre-existing conditions revolves around portability. Because most Americans donāt own their own health coverageātheir employers doāwhen people lose their job, they lose their health coverage. The pre-existing condition problem emerges when people develop a costly medical condition while at one job, then have to switch jobs or otherwise leave their employer plan.
Solving the portability problemāallowing health coverage to go from job to jobāwould go a long way towards solving the pre-existing condition problem. Of course, Democrats donāt talk about solving the portability problem because they donāt want to solve it. They want the government to control everything through a single-payer health care system. Thatās why they spend so much time talking about a symptom (people with pre-existing conditions who canāt get coverage) rather than the underlying disease (coverage not being portable).
But if people owned their own insurance policies, they could change jobs easily, without fear of losing their coverage. Moreover, they would get to pick the kinds of benefit designs and doctor networks they want, rather than being stuck with what their employer picks for them.
The final rule accomplishes both objectives. It enhances portability by allowing employers to give their workers a (tax-free) contribution to an HRA, so employees can buy the plan that works best for them. If thereās any difference between the employerās contribution and the total premiumāfor instance, an employer contributes $300 per month, and the worker selects a plan with a $350 monthly premiumāthe worker can pay the difference on a pre-tax basis, so long as he purchases the plan outside of the Obamacare exchanges. Best of all, because employees own the plans and not the employer, they can keep their coverage when they change jobs.
This change also improves affordability, in two key respects. First, individuals can buy just the coverage they want, rather than the coverage their employer gives them. Currently, if an employer plan offers particular benefits that an employee does not value, or a provider network a worker does not need, the worker can only buy an alternative plan by forfeiting their employerās subsidy towards their health insuranceāan unattractive and irrational option for most. The HRA option will allow workers to retain their employerās subsidy, yet purchase more tailored coverage.
Second, more people purchasing coverage individually will create a more robust marketplace, increasing competition. Carriers may move into the market for individual coverage, and even create new options to attract additional businessāboth changes that will help consumers, and mitigate premium increases.
The final rule does include important safeguards to ensure that businesses donāt just try to ādumpā their sickest employees onto individual insurance plans, raising premiums on the Obamacare exchanges. Most notably, if they elect the HRA option, firms must apply it to an entire class of workersāfor instance, all full-time workers, or all workers in a certain geographic area. Moreover, employers cannot vary their contributions to workersā HRAs, except by the employeeās age and number of dependents.
The rule could eventually lead to dramatic changes in Americansā health-coverage options, but it includes provisions designed to phase those changes in over time.
Trump Administration Gets Smart On Pre-Existing Conditions
As I first explained when the administration proposed this HRA rule back in October, much of the problem surrounding pre-existing conditions revolves around portability. Because most Americans donāt own their own health coverageātheir employers doāwhen people lose their job, they lose their health coverage. The pre-existing condition problem emerges when people develop a costly medical condition while at one job, then have to switch jobs or otherwise leave their employer plan.
Solving the portability problemāallowing health coverage to go from job to jobāwould go a long way towards solving the pre-existing condition problem. Of course, Democrats donāt talk about solving the portability problem because they donāt want to solve it. They want the government to control everything through a single-payer health care system. Thatās why they spend so much time talking about a symptom (people with pre-existing conditions who canāt get coverage) rather than the underlying disease (coverage not being portable).
But if people owned their own insurance policies, they could change jobs easily, without fear of losing their coverage. Moreover, they would get to pick the kinds of benefit designs and doctor networks they want, rather than being stuck with what their employer picks for them.
The final rule accomplishes both objectives. It enhances portability by allowing employers to give their workers a (tax-free) contribution to an HRA, so employees can buy the plan that works best for them. If thereās any difference between the employerās contribution and the total premiumāfor instance, an employer contributes $300 per month, and the worker selects a plan with a $350 monthly premiumāthe worker can pay the difference on a pre-tax basis, so long as he purchases the plan outside of the Obamacare exchanges. Best of all, because employees own the plans and not the employer, they can keep their coverage when they change jobs.
This change also improves affordability, in two key respects. First, individuals can buy just the coverage they want, rather than the coverage their employer gives them. Currently, if an employer plan offers particular benefits that an employee does not value, or a provider network a worker does not need, the worker can only buy an alternative plan by forfeiting their employerās subsidy towards their health insuranceāan unattractive and irrational option for most. The HRA option will allow workers to retain their employerās subsidy, yet purchase more tailored coverage.
Second, more people purchasing coverage individually will create a more robust marketplace, increasing competition. Carriers may move into the market for individual coverage, and even create new options to attract additional businessāboth changes that will help consumers, and mitigate premium increases.
The final rule does include important safeguards to ensure that businesses donāt just try to ādumpā their sickest employees onto individual insurance plans, raising premiums on the Obamacare exchanges. Most notably, if they elect the HRA option, firms must apply it to an entire class of workersāfor instance, all full-time workers, or all workers in a certain geographic area. Moreover, employers cannot vary their contributions to workersā HRAs, except by the employeeās age and number of dependents.
The rule could eventually lead to dramatic changes in Americansā health-coverage options, but it includes provisions designed to phase those changes in over time.
