The North Carolina Farm Bureau wants to sell underwritten health benefit plans next year. The Republican supermajority in the North Carolina state legislature is considering the idea of authorizing “non-profit health benefit plans” that aren’t insurance despite quacking and walking like insurance.
My analysis of the similar plan in Iowa stands:
And if an individual can pass underwriting and does not qualify for significant ACA subsidies, these plans are a good deal as that group of people are mainly looking for hit by a meteor protection. Well subsidized individuals will be indifferent to these plans as the subsidies buys affordable comprehensive insurance on the Exchange. The people in trouble from this scheme will be individuals who either can never pass underwriting or will pass with so many upcharges or restrictions that passing is still pointless. Their options are to either move out of the state or to drop their incomes so that they qualify for ACA subsidies….
But at some point this is fundamentally irrelevant. The upcoming short term limited duration (364 day) plan rule and the association health plan rule will do the same thing. Those two rules will create very large outs in the ACA individual market for people who can pass underwriting. The Farm Bureau wants to underwrite and it won’t be much different except that it will be called a “non-profit health benefits plan” instead of “health insurance”.
Allowing the Farm Bureau to sell these unregulated plans won’t be much more than allowing slightly worsening of morbidity within the ACA QHP risk pool as the damage would have been done already.