There’s just one small problem: The individual insurance marketplace could unravel without them.McSally says the bill is getting better and better, thanks to her hard work:
Remember how the EHBs made the marketplace viable, because they helped pool risk among the whole of the population, requiring everybody to pay a little for basic health care even if they aren’t going to use it, instead of just attracting sick people who may need those services?
“Without these requirements, you are looking at an individual market where the only policies available are extremely skimpy or expensive,” said Matthew Fiedler, a fellow at Brookings who served as chief economist of the Council of Economic Advisers, where he oversaw work on the Affordable Care Act. In the past, insurers had strong incentives to design plans in ways that were unattractive to people with predictable health needs or sick people. And getting rid of the essential health benefits, Fiedler said, “would give them a powerful tool to avoid people that expect to need care.”
Within two or three years, Blumberg expects more comprehensive coverage plans to dry up. Since insurers can’t deny coverage outright, and many will be tempted to go down to more limited polices that attract healthy people, insurers offering comprehensive policies would likely attract more sick expensive patients, which would create a selection problem and make the plans unsustainable.
Getting rid of EHBs would also make the promise of covering people with preexisting conditions meaningless. If a cancer patient or person with diabetes can get coverage but the cost of their chemotherapy or insulin isn’t covered, that coverage isn’t meaningful anymore, Blumberg said.
The amendment we successfully negotiated today is another important win for families. It secures an additional $15 billion to offer crucial care for mothers and their newborns, and for those who struggle with mental health disorders and substance abuse. The Affordable Care Act simply isn’t working, and this victory is another step in the right direction. By giving the states support to implement a smooth and stable transition, this amendment will prevent individuals who need healthcare the most from slipping through the cracks. We aren’t landing a helicopter, we are landing a 747, and we need a lot of runway to ensure a smooth transition to a system that lowers costs, expands choice, and increases quality of care. This amendment lengthens that runway.It's more like you're landing a flaming dumpster, Congresswoman McSally.
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