Even With Harvey, Insurance Debate Goes On

With what’s happening in Texas, it’s hard to concentrate on insurance coverage. But you won’t want to miss this one: Julie Rover from Kaiser Health News outlines 5 Outside-The-Box Ideas For Fixing The Individual Insurance Market. Here’s a quick run-down of the five ideas:

1. Allow people into Medicare starting at age 55.
Lowering the age for Medicare (by allowing people to purchase coverage early or letting them join on the same terms as 65-year-olds) is controversial to say the least. Some Democrats support it as a first step toward a single-payer, Medicare-for-All system. Most Republicans oppose it on the same grounds.

2. Allow people to ‘buy in’ to Medicaid.
Democratic Senator Brian Schatz (D-Hawaii) is pushing a federal Medicaid buy-in plan. It would give states the option to allow people with incomes over current Medicaid eligibility thresholds to pay a premium to join the program. Like the Medicare buy-in bill, it would allow those who qualify for federal tax credits to use them to pay the premiums.

The proposal would also raise the amounts Medicaid pays to doctors, hospitals and other health care providers to the same level as it pays for Medicare patients. Because an expansion would raise Medicaid spending considerably, though, there’s little chance it will pass muster with conservative policy analysts.

3. Get younger adults off their parents’ insurance and back into the individual market.
It’s widely believed that this has a snowball’s chance in Houston of passing. Keeping young adults on a parent’s policy is basically a middle class giveaway. Any middle class giveaway will be excruciatingly difficult to take away.

4. Require insurers who participate in other government programs to offer marketplace coverage.
In an effort to strongarm encourage private companies to step up, some analysts have suggested tying participation in other government programs to ACA policies. For example, some have suggested insurers be required to provide policies in the marketplaces as a condition of being able to offer coverage to federal workers. Others have suggested that providers of Medicare Advantage plans may also be required to offer individual exchange coverage. One glitch is that the same rural areas with a lack of private individual market insurers also tend to lack Medicare Advantage plans.

5. Let people use HSA contributions to pay health insurance premiums.
A little-noticed provision in one of the versions of the Senate GOP health bill that failed to pass in July would have allowed people to use money from tax-preferred health savings accounts (HSAs) to pay their insurance premiums. There’s support from ideologically diverse health care experts, but some drawbacks. Namely, if people use their HSAs to pay premiums on HDHPs, there will likely be little or no money left to pay any out-of-pocket expenses.Still, expect to hear more about this idea.