It happens so often now that it has stopped being remarkable: another health insurance company leaves the Obamacare exchange. Near the end of May, Blue Cross and Blue Shield of Kansas City announced it would be exiting the Missouri and Kansas exchanges, causing 67,000 people to lose coverage. That will likely leave people in 25 Missouri counties without an insurer in the individual market.
There is an opportunity here for congressional Republicans, one that could both bridge the gap between moderates and conservatives over Obamacare repeal and give them a big boost going into the 2018 election.
The moderates in the GOP want to keep Obamacare’s protection for pre-existing conditions. It is an understandable position, as protecting people with pre-existing conditions is compassionate, and it does not make for good press to have some of the sickest people lose insurance.
More conservative Republicans would rather repeal every last piece of Obamacare, including the protections for preexisting conditions. That, too, is an understandable position, since those “protections” are a major cause of the Obamacare exchanges’ death spiral. It is why insurers are exiting the exchanges and thousands of consumers are losing their insurance.
Republicans can bridge that gap with what can be called the Federal Consumer-Based High Risk Pool (FCBHRP). Here’s how it would work:
HTAs are similar to a concept known as “reference pricing.” When reference pricing was used for hip and knee replacements in California, costs dropped by over one-third. For a bibliography on reference pricing, go here.
The FCBHRP offers moderate Republicans the chance to credibly go before voters and say that they have helped those who are losing insurance on the Obamacare exchanges and have pre-existing conditions. It offers conservative Republicans a way to say that they offered such help in a way that keeps costs down and promotes markets in health care.
Finally, the FCBHRP offers the entire GOP a way to use the Obamacare death spiral to their advantage. By including the FCBHRP in their health care overhaul, congressional Republicans can argue that passing health care legislation is the only way to help people who are struggling because Obamacare exchanges are imploding. They can say the bill to repeal and replace Obamacare will provide timely assistance to the 67,000 people in Missouri or the 70,000 in Iowa who will lose their insurance at the end of this year.
And if Senate Republicans were truly crafty, they would offer the FCBHRP as an amendment to their health care legislation and dare the Democrats to vote against it. Imagine a Senate Democrat running for reelection in 2018 in a state where people are losing their exchange policies. If said Democrat were dumb enough to vote against FCBHRP, the Republican challenger would have a potent issue to exploit.
Crossposted at Bombthrowers.