KHN - New consumer-controlled health insurance plans could get seed money from the government to increase competition – and maybe cut prices -- under new rules announced Monday by the Department of Health and Human Services.
Story and details provided by Kaiser Health News in HHS Sets Rules for Consumer-Controlled Health Plans
Please read the complete story at the link above.
The strategy is that new health plans run by consumers – most board members would also have to be plan members -- would find ways to improve care, rather than boost profits. The new plans, made possible by the seed money, would also compete with established insurers to drive prices down.
If you read the story you will find that while this all sounds great in concept, actually bringing it to fruition is full of hurdles - a major one being that these insurance co-ops will have to meet funding guidelines set by the state to insure their solvency while at the same time they are restricted to covering the most expensive part of the health-insurance population and one that is always discriminated against in terms of fees by the standard industry - small business and individual consumers. Plus:
But co-ops could face another hurdle as they seek approval from their state regulators, said Sabrina Corlette, a professor at the Health Policy Institute at Georgetown University. Because most regulators count repayable loans as a debt, it might not help meet state solvency requirements for health plans.
Some nonprofits that hoped to set up co-ops "probably got a dose of cold water in terms of the cash they'd have to put up" when they approached regulators, she said.
Sounds like the cards are stacked against these non-profit co-ops making it into the real world where some of us might reap the benefits.
I agree that the concept sounds exciting - non-profit consumer run and controlled insurance plans bypassing the existing insurance industry.
But why are they restricted to the most problematic part of the healthcare population? That part sounds like a poison pill in the legislation that it makes them seem "designed to fail".
I sadly don't think this plan will go far or do much to solve the problems we still all face under the ACA - being the unwilling slaves to the existing insurance industry.
I don't think this plan is the same as the part of the ACA under a lot of discussion yesterday - a multi-state non-profit plan run by the Director of the OPM. But, as always, feel free to correct me if I am mistaken.
Single payers always has been and always will be the one best answer. A public option is the only second-best alternative.
Everything else will be proven in time to be piecemeal, time-wasting, money wasting exercises in futility, even if done with the best of intentions.