I think repugs think because it works for car insurance it will work for health. Two very different things.

Contracting to achieve in network providers, hospitals, laboratories, etc. is necessary for insurance companies to provide affordable care.

was missing a big detail of the ins/state workings.

If you sell insurance in all fifties states you need networks, i.e. physicians, hospitals, labs, rehabilitation centers, physical therapy centers in all fifty states.

It's not like car or home insurance where a pay out is a pay out, and even there state plans are individualized.

Won't allow other Blues to sell insurance in outside states with other Blue Plans operating in those states. I guess that's why it seems the GOP are kicking that can down the road.

They really should just expand Medicare to the uninsured, allow the states to pick the insurance company to administer the Medicare Plan with 100% funding from the federal government and increase everyone's Medicare tax to pay for it.

Over time Phase out private insurance or give people a choice between the two.

The Association doesn't say that they can't sell in other states, but the "home" company must always have the right of first refusal. That can come into play when things like a large group account is allowed to buy their coverage from a "Blue" in another state because the one in their area is smaller and maybe doesn't have the capacity to handle that account.

If a Blue wants to sell in another state and the other Blue says no then out of state Blue is out of luck.

It is much more strict than first refusal, which also is an antitrust violation.

Everyone hates BCBS.

At DKOS exactly to that point. I sold and serviced health policies. The lines thing is code for allowing companies to sell in your state but bypass your insurance commissioner. They will headquarter in a state with almost no rules I mean Texas. You will have no recourse or protection for fraud. That has always been a must have in all Republican plans. Con men will have a field day.

In all my time as an employee - where offered by my employer - I only had one option.

And BlueCross/Blue Shield, by any other name, is still BCBS. In every state.

Some are for profit and some are not for profit. But BCBS of Montana is an entirely separate company from BCBS of North Carolina.

Is that the game you want to play?

They aren't franchises, they are separate companies under the umbrella of an association. But thanks so much for the snarky tone.

The point I'm making is they are in every state.

I don't understand what your point is?

There is a difference between a for profit and non-profit organization. Glossing over that with snark just makes it clear you don't have any idea what you're talking about.

Non-profit insurance companies on average have lower premiums and out of pocket costs.

But apparently to you, being a well informed opinion is a game.

Always appreciate my fellow travelers completely missing the point!

BCBS plays games to be a player in every effin' state, but you are more than welcome to add your snark!

Great playing on the same team, isn't it?

The main reason why medical insurance costs less in Des Moines than in Chicago is that the cost of medical care........and the general cost of living.......is less there. And, for that matter, the costs are less in smaller downstate Illinois communities than in the metro area and premiums are proportionately less in those areas.

Those are just examples, but the point is that Humana or Aetna or Blue Cross charge different rates in different areas based on the difference in their costs from one place to another.

So it doesn't necessarily follow that if I live in NYC and buy my insurance from Clovis New Mexico Mutual Insurance Company that it will cost appreciably less. I wish someone would explain this to me because I hear both Democrats and Republicans touting this and it just doesn't make any sense to me.

All (or at least most) states have an insurance commissioner who's responsibility is to make sure that insurance companies follow state regulations if they want to do business there.

So, what the Repub wet-dream would do is create a race to the bottom where policies and coverages get leaner and leaner to "lower costs" and you State regulator will have no power to enforce protections for citizens in the state.

I don't know of that many. Fact is, insurance companies can already sell across state lines. They can sell anywhere, they just have to follow the state laws.

Globalizing health insurance/getting rid of local regulation will probably make some corporate execs, big investors, and their puppets in Congress fabulously richer than they are now!!!! Winning!!!!!



From the party of states' rights. Ha.

For instance BCBS is everywhere but is currently regulated by the states they do business in. What will happen is another company will headquarter in Texas or other jack leg state and sell crap in your state. They will only be bound by that states insurance laws. They will show a smaller premium but when the rubber meets the road there will be exceptions or limits. The public has no idea what they need the con men will flourish. It's the American way.

Republicans will remove the Obamacare requirement that all health plans provide minimum benefits. The insurance industry will go back to ripping off consumers by selling cheap, worthless policies to unwary consumers. Follow the money, these cheap policies are very profitable to the insurance industry.

Republicans don't care if these policies don't meet the minimum requirement in states like Calif and NY that have strict regulations for a high standard of patient care and consumer protection, they'll just override those laws. When it comes to corporate profits these so called 'states rights' Republicans want to get rid of states' rights and undermine the state's power to regulate what policies can be sold.

"Sell across state lines" is code word for relinquishing control from state regulatory Agencies to Federal. Which will no doubt be more lax in regulation vs. States such as California, Oregon, Washington, New York, etc. In addition, given the size, will be less effective on consumer complaints.

In a number of states this will no doubt change actuarial formulas. In several states, rating is required to be done mostly if not all, lost cost experience of the state of operation. States with higher health and environmental regulations obviously benefit by this, whereas states with lax laws obviously have higher premiums. Thus the insurance company will now rate based on national and not individual state.

As an example, lets say North Dakota has stronger enforcement and stricter laws with Auto's on roads. As a result, less accidents and less severe ones. Which in turn yields lower auto premiums. But say South Dakota is fast and loose and horrible on enforcement, thus higher Premiums. Before, rating is done within each state, now, both states are part of it. South Dakota will see its premiums decrease while North Dakota see's its rise. Thus North Dakota pays for the recklessness of South Dakota.

It's essentially a GOP reckless state finding a way to sweep their horrible record under the rug. Insurance companies can skirt this by developing "rating territories"....but its a good bet the GOP will limit how much they can deviate from a state to state basis.

And....and I think this is why they are walking back from "across state lines" issue. It will be essentially a Federal appropriation of State Tax Revenue to Federal. State's charge premium taxes, filing fee's, etc. This money funds, jobs, safety programs, etc. Many states would cry foul and could be a PR nightmare.

Before letting card companies cross state lines, the rates were like 6% or 7% because of state laws. When allowed to cross state lines, all most all of card companies moved to Delaware where the rates were way higher. Next thing that happened, 14% to 28%.
The Banks were very happy.

Whoever gives you the worst product wins!