I recently put up a diary on Medicare Buy In in which I estimated the cost of Full Premium Paid Medicare Insurance compared to private sector insurance. In that diary it seemed that Medicare premiums would be 17.6% less than private rates and this was true even as the private insurers limited their activities to "healthy people" without preexisting conditions. At that time I committed to creating a "Medicare Buy In" page in DKospedia. That page has been created and populated and extended to include a look at State Based and National Risk Pools for those who are not healthy.
At the time I Wrote the "Medicare Buy In" Diary I received several comments that were of benefit. The two that were seemingly most appropriate were one about adverse selection and one about providers running away from Medicare reimbursement rates. I quickly came to the conclusion that without PPACA there would be an instantaneous flocking of people in state based risk pools into the Medicare Buy In, thus dramatically undermining the Medicare budget/projections. I originally though that this meant that Medicare Buy In had to be postponed until 2014 when the separate risk pools are merged with the standard policies. But what I am seeing in the pricing of the Federal risk pools tells me something different. The Federal risk pools are available for most of the Red states right now. Most of the blue states have decided to keep their state based pools. I live in Washington State and people I know who have no choice but the risk pool are currently just out of luck. The state of Washington seems to be "in bed" with the insurance companies, fleecing the preexisting conditions people. The state of Washington and other states that had their own risk pools are holding on to their power and screwing the people. It appears to me that if the states were to get out of the way and allow PCIP to administer the risk pools then we would all be better off and we would not need to wait until 2014 to legislate Medicare Buy In. The Federal risk pools are very competitive with my computed Medicare Buy In rates. As such there will be no adverse selection. People with preexisting conditions will opt for the federal risk pools until they are dissolved in Jan. 2014.
Your comments are appreciated.