You can’t have a fair game, if the people involved play by two different sets of rules. As the U.S. Senate continues its effort to overhaul the Affordable Care Act – which sets the rules for how insurance companies behave toward consumers – it is considering giving insurers the ability to serve our customers under two different sets of rules. This idea is well-intended, but ultimately isn’t helpful toward our goal of promoting affordable insurance coverage for every American. Insurance of any kind is best kept affordable when everyone is covered and has the same choices of coverage. A provision in the Senate legislation, however, would allow health insurers to offer two types of plan options – those that offer comprehensive benefits like the existing law requires; and plans that offer bare-bones benefits that the law currently prohibits. The theory is that comprehensive benefits make coverage more costly, and the plans required by the ACA are keeping healthy people out of the insurance system. But the required benefits aren’t the only factor in pricing, as told by our recent premium increases in Michigan’s individual market. Furthermore, this proposal creates two separate insurance systems – one for healthy people and the other for people with pre-existing conditions. It will draw healthy people away from the comprehensive plans and into another distinct market. This migration of healthy people into bare-bones plans will cause prices to jump even higher for people with pre-existing conditions who remain in the comprehensive plans. On July 14, the Blue Cross and Blue Shield Association joined another trade association, America’s Health Insurance Plans, in signing a letter to the bipartisan Senate leadership opposing this provision of the broader legislation. We hope the Senate hears our concerns and relies on our expertise. For decades in Michigan, Blue Cross Blue Shield of Michigan was the only health insurer to accept people with pre-existing conditions for coverage on a year-round basis. Our experience tells us how expensive health coverage can and will get for people with pre-existing conditions, if a separate market is created for the young and healthy. As efforts toward health reform continue, Blue Cross Blue Shield’s principles call for a system where all people are covered and where people with pre-existing conditions are protected in locally regulated markets where all insurers play by consistent rules. Working together with policymakers from both sides of the debate, we believe we can improve the system and give people the security, access, choice and affordability they deserve. Photo credit: A Healthier Michigan
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