Claire introduces bill to allow ppl in counties w/out insurers on individual marketplace to buy same

[MelissaB]

BREAKING: Claire introduces bill to allow ppl in counties w/out insurers on individual marketplace to buy same plans available to Congress.

Link to tweet

[greymattermom]

1. So would these insurers exit the federal market too?

or is that market just too big to ignore?

[Demsrule86]

10. I think that is her point.

It could be a requirement that insurers stay in ACA or no Fed market for them...Insurers are dropping out so they can have GOP goodies like higher salaries and foist sick people to pricey pools in order to make more profits.

[a kennedy]

2. D*mn right, I'll have what she has. That's all I've ever wanted was what congress has. eom

[House of Roberts]

3. Doesn't this amount to allowing insurance companies

to operate across state lines?

[SHRED]

4. My first thought too

[Demsrule86]

9. No...there are many states like Georgia that did not extend Medicare and did not

do their own state plan.

[cbdo2007]

11. All states have Federal Employee Program plans for those federal employees.

They are run by the local insurers but are managed at the federal level, similar to how Medicare and Medicaid are handled in each state.

[House of Roberts]

12. So a Fed employee in Alabama

would have Alabama Blue Cross/Blue Shield? Hence, an Alabama individual with no option on the marketplace would be allowed to buy that, and BC/BS would have to let them buy in? I wonder how expensive that would be?

[Scruffy1]

18. Every federal district has different insurers.

The federal insurance is under Benefeds. They don't really manage it, but the insurers have to meet specific rquirements to be listed. Where I live we have a choice between Blue Cross, Medica, Health Partners and maybe one more. If you live in DC there are a lot more. It's really the same as any other group insurance and it's not cheap. I get so tired of hearing about rediclous federal benefits from the unknowing. The last year i worked my family plan was $18,000 per year, and typically federal employees pay 50%. Unless you have a really good paying job, it is beyond the reach of the average hourly emplyee. I worked for the USPS, so we got a little better deal and only paid 40%, while congress critters paid 50%. This was a union advantage. Even then, I couldn't afford the "deluxe" plan as it would have cost me $700. per month. Instead you get saddled with copays, so it comes out about the same if you have health problems. This might make a good sound bit, but it is no solution to the high cost of health care.

[House of Roberts]

19. In Alabama, BC/BS is about it.

My ex had United Healthcare, which is good where her corporate headquarters is, but here few providers take it.

[Wounded Bear]

20. The "across state lines" thing is a bogus RW talking point...

they already can. They just have to follow the rules where the plan is sold, not the rules in the most lenient state in the country.

Frankly, it is a blatant attack on that sacred cow of Repubs, "States rights." It removes the ability of states to protect their citizens from corporate malfeasance.

[Ms. Toad]

5. Nice concept, but there are some pretty significant logistical issues

Most plans are specific to the local providers. They don't provide coverage (other than emergency) outside of the geographical area in which they have negotiated contracts. Or - at best - they provide out-of-network rates. For out-of-network rates, there is typically no negotiated discount - but insurance is capped at the UCR for that service. The insured picks up the rest of the bill.

For example, a typical lab bill for me: $120, discounted to $12 for the insurer, I pay 15% of that - $1.80 so the insurer pays $10.20, the lab eats the $108 discount.

Out of network, I would typically have a higher copay (perhaps 25%), and there is no discount, but the insurer pays as if there were. So in that scenario, the insurer pays $9 (75% of the discounted rate), I pay $111, because the provider is not under contract to accept the discounted rate.

(Labwork is the most heavily discounted - at 80-95%, but most insurance discounts are significant. If out of network costs are covered at all, you typically lose the benefit of whatever discount there is.)

[Trekologer]

6. Medicare buy-in would be better

The same insurance Congress buys is just for show. Make it a real step toward single payer at the same time.

[Demsrule86]

8. I disagree ...this is very clever and puts it on Congress to explain why they get health care and

others don't. Everyone knows we are for single payer.

[dae]

14. Agree! Another hole for GOPers to fall in and crawl out of!

[Demsrule86]

23. The more holes the better...one hopes for at least a broken leg...

[Demsrule86]

7. That is clever.

[aeromanKC]

13. Very good, but once again Access does NOT equate to coverage

How will someone working for $15/hour going to afford same Health care coverage as what Congress has?

[LittleGirl]

17. Post win!

welcome to DU!

[Wounded Bear]

21. Presumably there are subsidies in the plan...nt

[SHRED]

15. At what cost?

Affordable?

[SunSeeker]

16. Sounds good to me!

[Lee-Lee]

22. And what does that cost when the individual is paying?

I can walk into a new car dealer and they will allow me to buy all I want, but if the cost isn't what I can pay it doesn't help me one bit...