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Health Experts Agree: Insurance “Across State Lines” Still Possible

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Michael Petruzzelli

, National Council for Behavioral Health

Health Experts Agree: Insurance “Across State Lines” Still Possible

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As health care debate and reform continues on Capitol Hill, one long-term conservative goal that still remains is the prospect of selling insurance across state lines. Such a development could be potentially disastrous for addiction and mental health providers across the country as experts fear plans would kick-off a “race to the bottom” and sell insurance from states with fewer mandates and regulations. As the Senate continues deliberations on health reform legislation, it is imperative advocates stay informed and engaged to prevent these devastating policy changes.

When the House approved the American Health Care Act earlier this month, it did so largely on the condition of two amendments just prior to the vote. One of those amendments, the MacArthur amendment – named after moderate Republican Congressman Tom MacArthur of New Jersey – allowed states the option to waive a number of crucial protections that were implemented as a part of the Affordable Care Act.

The amendment, which was adopted and subsequently approved in the final bill before the House, would allow states to define its own set of required health services, it would allow insurers to charge consumers more for pre-existing conditions, and it would allow insurers to charge sicker, older Americans more for health care coverage.

Health experts are now convinced that with these changes, allowing insurance companies to sell across state lines would fundamentally change the American health care landscape. “If any one state waived community rating,” said Larry Levitt of the nonpartisan Kaiser Family Foundation to POLITICO last week, “it would be almost impossible to keep that in other states.”

“The plans can be skimpy, charge older people more and young people less,” said Edwin Park, vice president of health policy at the Center on Budget and Policy Priorities. “It would siphon off the good risk and drive up premiums for older and sicker people.”

A little-known provision in the Affordable Care Act allowed for large employers to adopt the benefit package of another state. However, with the nationwide enforcement of the “Essential Health Benefits”, few individuals were in jeopardy of being denied access to comprehensive, meaningful health care coverage. However, as currently drafted, the American Health Care Act would allow states to remove this base of coverage requirements, offering few required services potentially leaving millions at risk.

As the Senate continues its work on health reform legislation, advocates should be aware of the potentially dangerous implications of this proposal. As always, the National Council asks advocates to speak and engage with us in this campaign to educate and influence lawmakers and their staff in our effort to #Unite4BH.

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