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You are here: Home / Anderson On Health Insurance / AHIP on kersploding markets and single payer

AHIP on kersploding markets and single payer

by David Anderson|  September 21, 20177:02 am| 31 Comments

This post is in: Anderson On Health Insurance

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Adrianna MacIntyre, as usual, has a very keen insight on single payer:

Functional market-based health insurance makes single-payer less likely, not more.

Kersploding those insurance markets, otoh

— Adrianna McIntyre (@onceuponA) September 19, 2017

AHIP, the big health insurance lobbying group released a letter regarding Cassidy-Graham-Heller-Johnson.  They aren’t fans.  Here are the last couple of paragraphs:

And finally, reforms should rely on the strengths of the private market, not build a bridge to
single payer systems. To best serve every American, we need both a strong private market and an
effective role for and partnerships with government. Building on the choice, competition and
innovation of the private sector and the strength, security and dependability of public programs is a
far more effective solution than allowing states to eliminate private insurance.

The Graham-Cassidy-Heller-Johnson proposal fails to meet these guiding principles, and would have
real consequences on consumers and patients by further destabilizing the individual market; cutting
Medicaid; pulling back on protections for pre-existing conditions; not ending taxes on health
insurance premiums and benefits; and potentially allowing government-controlled, single payer
health care to grow.

While we cannot support this proposal, we will keep working to find the right solutions that reflect
the commitment we all share: affordable coverage and high-quality care for every American. By
working together, we can improve health care and deliver the coverage and care that every American
deserves

AHIP does not want a kersploding individual market. They don’t want a kersploding Medicaid managed care market. They don’t want this for two reasons. First, the primary reason is simple. Dramatic decreases in enrollment suppresses revenue. More subtly, a functional individual market where the buying entity is the individual with subsidies is a massive bulwark against single payer systems that would drive most of them out of business and transform the rest into claims processing utilities. They are betting that the individual market in the CGHJ world will be a mess which will lead to public demands to do something and that something by Democrats is something that they don’t want.

No one wants this bill.

So keep on calling.

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Reader Interactions

31Comments

  1. 1.

    rikyrah

    September 21, 2017 at 7:20 am

    Thanks for the info, Mayhew.

  2. 2.

    BlueDWarrior

    September 21, 2017 at 7:23 am

    Makes you wonder how many of these insurance lobbying groups are going to understand the Democrats, at least the more centrist and capitalist-left parts of the party would really like to not have to go all-in on single payer in the next 5 years, but if they [insurance cos.] continue to beat around the bush, their hands are going to be forced by idiot Republicans deciding that you should pay for Cancer treatments the same way you’d pay for a relatively expensive computer – because they are totally the same thing.

  3. 3.

    rikyrah

    September 21, 2017 at 7:25 am

    CALL CALL CALL!!!

  4. 4.

    Patricia Kayden

    September 21, 2017 at 7:26 am

    No one wants this bill.

    Except Republican politicians in Congress and Trump, unfortunately. Hopefully they are hearing from angry constituents right about now.

  5. 5.

    Baud

    September 21, 2017 at 7:27 am

    More subtly, a functional individual market where the buying entity is the individual with subsidies is a massive bulwark against single payer systems

    IMHO, it’s employer based insurance that is the bulwark against single payer.

  6. 6.

    BlueDWarrior

    September 21, 2017 at 7:33 am

    @Baud: You can consider it a double bulwark, with employer insurance the bigger wall, and the individual market a smaller one in back of it.

  7. 7.

    Baud

    September 21, 2017 at 7:35 am

    @BlueDWarrior: Agree. That’s more accurate.

  8. 8.

    But her emails!!

    September 21, 2017 at 7:57 am

    @BlueDWarrior:
    Both of these walls are going to ultimately kersplode if this bill is passed. Part of the reason the ACA was passed in the first places is that the healthcare obtained thru employers was being seriously eroded.

    On the flip side, does anyone honestly think single payer is getting done in 5 years if this bill passes and Republicans trash our Health Care and Health Care Insurance system? Democrats always get burned on this. They provide something for the public and the public rewards them by voting them out of office. If the pattern holds, they’ll try to get something through in 2036

  9. 9.

    Baud

    September 21, 2017 at 8:03 am

    @But her emails!!: No, we’re imprisoned by political fantasy. Literally the only way we get single payer in that timeframe is if we suffer a WWII type devastation where no body has access to medical care. No way there’s more than a 45% chance that happens.

  10. 10.

    Chyron HR

    September 21, 2017 at 8:31 am

    @But her emails!!:

    On the flip side, does anyone honestly think single payer is getting done in 5 years if this bill passes and Republicans trash our Health Care and Health Care Insurance system?

    What part of “a bird landed on his podium” do you neo-liberals not UNDERSTAND???!!!

  11. 11.

    Peale

    September 21, 2017 at 8:35 am

    @But her emails!!: pretty much. I think we can get single payer if the Dems pass a bunch of laws that make it appear that only white people will get it first and that we’re repealing a bunch of non-existent black welfare programs.

  12. 12.

    VOR

    September 21, 2017 at 8:40 am

    I think I’ve figured out how to reconcile some of their claims with reality. They keep saying this bill doesn’t revoke pre-existing condition coverage. They claim their bill doesn’t remove essential elements of coverage. But their bill ALLOWS states to do these things. And you know many states will do these things. But Cassidy-Graham doesn’t do it directly. I think they are claiming THEY aren’t removing coverage, it is just up to the states if they want to do that in the future.

    It is hard to be cynical enough. This is like handing a loaded gun to a maniac and then saying it wasn’t your fault he shot people.

  13. 13.

    rikyrah

    September 21, 2017 at 8:43 am

    Just called Lisa Murkowski’s office & was told they WELCOME calls from those outside the state.
    Please call! 202.224.6665 #GrahamCassidy
    — ❄️Mama Snowflake❄️ (@northeast_mama) September 18, 2017

  14. 14.

    rikyrah

    September 21, 2017 at 8:43 am

    David ?Canadian Anchor Baby? Koch says:
    September 19, 2017 at 7:55 pm

    So I decided to call McCain’s office regarding ACA

    What the hell: though I’m not an AZ resident, I have a relative who is.

    Phoenix – (602) 952-2410

    Tucson – (520) 670-6334

    WashingtonDC (202) 224-2235 – press #1

    The DC has voice mail, at first the automated message suggests using email, but if you hang on it will connect you to voicemail.

    I asked him not to vote for bill that has no bipartisan support, nor a bill that only has 50 votes, nor a bill that tampers with pre-existing conditions, nor a bill that tampers with medicaid.

  15. 15.

    rikyrah

    September 21, 2017 at 8:47 am

    Scott says:
    September 20, 2017 at 11:28 am
    John, you don’t have to fax from your printer. Use faxzero.com. You fax your letter from your computer. The Senate and Reps fax numbers are preloaded and all you have to do is change the Dear so and so part. Real easy. You can hit 2 senators and a rep in about 5 minutes tops.

  16. 16.

    rikyrah

    September 21, 2017 at 8:48 am

    Jim, Foolish Literalist says:
    September 20, 2017 at 11:29 am

    That is what “they” say. I think Indivisible is one of the “they”. Try RESISTBOT– Fax from your phone. I send a fax through them every day. Call in the morning, fax in the afternoon.

  17. 17.

    rikyrah

    September 21, 2017 at 8:49 am

    MomSense says:
    September 20, 2017 at 11:44 am
    @Mike:

    YES I was just about to post it. I get fireworks now as an “elite” resister.

    Text “resist” to 504-09. Super easy and quick.

  18. 18.

    rikyrah

    September 21, 2017 at 8:51 am

    Remember’s Kay’s helpful hints about bringing up Rural Providers:

    Kay says:
    September 20, 2017 at 12:03 pm
    I take a little different approach. I name-drop the local hospital and mention it is the single largest employer in the county- which it is. It’s fudged a bit- they’re the largest but they have lots of 30 hour people, but still. True.

    They’re paranoid about rural hospitals – all of them. I feel it’s a vulnerability for the GOP that screams to be exploited :)

    ………………………………………………………..
    If you have a big provider or best yet, a SINGLE provider, mention that. A lot of people work there. It would be a real body blow to a lot of these places if people had to travel 30, 40, 50 miles for health care, especially elderly people.

  19. 19.

    rikyrah

    September 21, 2017 at 8:54 am

    H.E.Wolf says:
    September 20, 2017 at 12:20 pm
    @Jim, Foolish Literalist:

    Faxzero.com allows you to compose a fax at their web page. They have lists of all the senators and reps, organized by state – and you aren’t limited to choosing your own state’s officials.

  20. 20.

    rikyrah

    September 21, 2017 at 8:56 am

    Sen @BillCassidy called our reading of his health care bill on pre-existing conditions false. Here’s how we read it: https://t.co/6vkONctK7B https://t.co/sA4wAEXvh3— NPR (@NPR) September 20, 2017

  21. 21.

    rikyrah

    September 21, 2017 at 8:56 am

    Anyone have the AARP number? Do they still have it when you call that number that they will then reroute you to your Congressman/Senator?

  22. 22.

    Scott

    September 21, 2017 at 8:57 am

    David, I was wondering about further implications of having 50 + state healthcare systems. Besides the incredible administrative inefficiencies, what is the impact on the mobility of the American workforce. Will there be people moving to get better healthcare? Will people resist moving at all? Will state start putting restrictions on new residents? etc

  23. 23.

    The Other Bob

    September 21, 2017 at 8:58 am

    I have always said that it is the insurance companies who should support ACA. If the R’s take down ACA, the Dems won’t be nice to the insurance industry the next time they have a chance to fix this.

  24. 24.

    rikyrah

    September 21, 2017 at 9:06 am

    “Trillion dollar loophole” in the Graham Cassidy bill that nobody is talking about yet (except this conservative website). Price can change the block grant formula any fricken way he wants.

    “…In other words, if the secretary of Health and Human Services (HHS) doesn’t like the funding formula, he can change it however he likes. That’s a trillion-dollar loophole that leaves HHS bureaucrats with the ultimate say over how much money states will receive.

    How Graham-Cassidy’s Funding Formula Gives Washington Unprecedented Power

    Which states will end up the proverbial winners and losers under the Graham-Cassidy bill? The answer is simple: Nope.

    http://thefederalist.com/2017/09/20/graham-cassidys-funding-formula-gives-washington-unprecedented-power/

  25. 25.

    tobie

    September 21, 2017 at 9:19 am

    @rikyrah: In a perverse way, this gives me hope. If even the conservative Federalist is against Graham-Cassidy, maybe it will go down in defeat. The article gives cover to people like Rand Paul and Mike Lee to vote no.

  26. 26.

    aimai

    September 21, 2017 at 9:45 am

    @Peale: They really want us to repeal “a black guy got to be president and was damned good at the job.” Where can they repeal that?

  27. 27.

    Barbara

    September 21, 2017 at 10:25 am

    @Baud: Employer provided insurance is only a wall against single payer if it covers nearly everyone who works. As fewer and fewer people are covered, often for less and less, the absence of an alternative individual market destabilizes nearly every piece of the health care industry.

  28. 28.

    TomatoQueen

    September 21, 2017 at 11:47 am

    @Scott: In a sense we have a lot of experience with this already, in the form of Medicaid. Medicaid is NOT portable among the states, which can lead to ugly surprises to families, who often aren’t aware of the consequences to their disabled family member should a move occur. States already have a lot of flexibility in eligibility determination and coverage, and what may be available even under the waiver system can vary considerably. Virginia has redesigned its Medicaid waiver system in the past year and even as an old hand at this stuff my eyeballs itch at the new jargon and resulting mystery. I’ve moved twice with Medicaid consequences, once to get away from Shithead–and to get better medical care and education for a boy, and once to get a better job for me, and even better education for a boy, and found Medicaid goodness and foulness as a result. Over time the parents I’ve talked to about this have either been forced into a move due to a medical need or economic circumstances, or they sit tight because the system they know is the one they know, no matter how much crap it makes them swallow. What they don’t do is deliberately consider a move, check out and compare the Medicaid differences, and make a decision based on available facts. I did that twice and am glad of it, in spite of the unspeakable effort involved. But I don’t think you can disregard how people and the strength of their connections to their community can operate against their own interests and, in spite of the prevalence of useful info about available resources, how difficult it is to make sane judgments about what often feels like stepping off a cliff into an ugly fog.

  29. 29.

    Matt

    September 21, 2017 at 11:57 am

    Here’s what I don’t get: word is that part of the GOP’s desperation to pass this is $400m in Koch money that’s conditioned on “something being done”. It’s terrible politics and would be illegal in a sensible country, but wouldn’t it be cheaper for the insurers to flat-out state, “it’s going to cost us more than that to fix the mess. Here’s $500m if you *don’t* pass it”?

  30. 30.

    Ohio Mom

    September 21, 2017 at 1:48 pm

    @TomatoQueen: We are one of those families who doesn’t consider moving because we are settled and connected, and because our autistic 20 year-old is on a $5,000 Waiver and on the waiting list for a more generous Waiver that could actually support him. Though he probably won’t reach the top of the waiting list until Ohio Dad and I are too infirm to manage and/or dead.

    Would we be better off somewhere else, I do not know but I do think about that from time to time.

    I also do not know how to do the type of research you are obviously an expert in! What is your secret? You should have a web site or be on a speaking tour.

  31. 31.

    Ohio Mom

    September 21, 2017 at 1:52 pm

    @TomatoQueen: P.S. Knowing the little I do know about how Medicaid varies from state to state, I snort every time some Republican talks about moving things down to the state level because “at the State level, they know better what their people need” — Medicaid administration is already “closer to the ground,” or whatever that silly expression they use is.

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