Tuesday, November 19, 2013
The bungled launch of the federal health insurance website has unleashed significant disorder -- but not everywhere. Life remains calm in many states that set up their own health care exchanges.
Some are so confident of the rightness of the health care reforms that they're rejecting President Obama's proposal to let people keep their inadequate health insurance policies.
"We will not be allowing insurance companies to extend their (substandard) policies," Washington state's insurance commissioner, Mike Kreidler, announced in no uncertain terms.
To recap, insurers canceled several million plans that failed to meet the higher standards of the Affordable Care Act. That left many policyholders angry. Anxiety rose as those in states relying on the federal exchange couldn't get on HealthCare.gov to see their alternatives (which might include pleasant surprises). Facing a revolt by purple-state Democrats, Obama said he'd give states the option of letting people keep their substandard policies.
The public is confused. Insurers are confused. Insurers are also upset because the move messes with the stability of the new insurance pools. The pools stay strong by combining the young and vigorous with the old and sick.
The banned bare-bones policies attract the healthy, though many are rip-offs worse than no insurance at all.
Again, the craziness is mainly confined to states that didn't set up their own exchanges. Most state exchanges are humming along, forcing rationality and cost curbing into their health care. Vermont and Rhode Island have joined Washington in saying "no, thanks" to the president's offer. No doubt others will join them.
"My jaw dropped" on hearing Obama's announcement, Kreidler told The Seattle Times. He added the obvious: "Insurance only works if you have a robust pool of good and bad risk."
By the way, about half of the 290,000 Washington residents who received cancellation letters will apparently qualify for subsidies to help buy insurance through the state exchange. Some may learn they can get more for less.
Of course, those in states dependent on the federal website can't see what's out there. Strange that red-state politicians, wedded to the idea that D.C. can't do anything right, left the job of setting up health care exchanges to the federal government.
Several are now being forced to extend their high-risk pools -- programs for sickly people rejected by private insurers. They are supposed to be phased out under Obamacare.
So Republican Gov. Scott Walker was only half-right when he complained, "In Wisconsin, we are taking action to protect our citizens from the federal government's failure." He neglected to include Wisconsin's failure to set up its own program.
We know what's going on. Most Republicans will not accept the reforms -- a virtual carbon copy of conservative blueprints, including former Gov. Mitt Romney's plan in Massachusetts -- because Obama wanted them. The politics are so perverse that they'll subsidize the health care of elderly billionaires, the destitute and prisoners but not the working poor and struggling middle class.
To the gasps of local hospital officials, many Republican governors refused to expand Medicaid to more low-income people, though the feds would have paid for nearly all of it. Only 25 states have agreed to the expansion, most run by Democrats.
One prays that the federal government will get its act together soon. In the meantime, let's put things in perspective.
As Jonathan Gruber, the MIT economist who helped design the Massachusetts and federal reforms, said on Fox News Channel, we should "stop panicking over days and weeks."
Also note that for every American with a canceled policy, there are 10 uninsured Americans. Many are suffering and will be saved by this law.
What can we say but, "Stay the course." Stay the course.
Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at firstname.lastname@example.org.
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