As we move into ACA “Repeal and Replace” discussions and action, consider Obamacare’s fundamental philosophical and economic paradoxes.
On one hand the ACA law is a boon to establishing government-insurance company cartels taking federal and state government money to “cover” US citizens who are not enrolled in Medicare, Medicaid, and the VA. Also, of course, the large ACA Medicaid expansion in Minnesota is administered through HMOs in cartel-TPA arrangements with our state government.
But what is the fundamental definition of Heath Care Insurance? The ACA flatly negates the principles of individual patient insurance risk underwriting by requiring “guaranteed issue” and removing all “pre-existing conditions” as coverage exclusions. So now, health care insurance companies must enroll all applicants based not on the likelihood of them incurring projected health care expenses but rather by the criteria of their economic status as defined by government-income classifications and thresholds. Therefore, it’s no surprise that insurance companies have dropped out of Mnsure and the MN individual insurance market. We’ll need to continue to pay off the insurance companies unless there is a proper definitions of health care insurance which is distinct from social health care entitlements.
2017? This year the Minnesota legislature decided to subsidize insurance companies who cover Minnesotans faced with huge increases in their health care premiums. There are current proposals to re-establish a Minnesota high risk pool to be administered internally within Minnesota insurance companies. This will allow them to unload expensive cases to taxpayers.
I’m thinking we should bring back a patient-centered high risk health care insurance pool in Minnesota modeled after the 1976 Minnesota Comprehensive Health Association plan http://mchamn.com/ which was phased out in 2013 because the ACA was supposed to be a refuge and safety net for patients and families with expensive medical conditions.