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Changing the Employee Benefit Conversation

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House and Senate GOP lawmakers are at odds over what to do about Pre-existing conditions as they try to repeal or replace ACA.  While this is certainly a moral issue it is also most definitely a key component of affordability.  If there are no rules pertaining to pre-ex then there can be no market stability.  There are definitely individuals who cannot afford health insurance and for these people (I believe) we have an obligation to provide care, but not necessarily insurance. 

In reality, Insurance protects the providers not the individuals.  Without providers, there is no healthcare. 

Medicare protects the elderly who paid during their working years and expect this coverage.

Medicare also protects the seriously ill/disabled who cannot provide for themselves.

Medicaid protects the poorest of the poor. 

Everyone in between can only turn to the commercial insurance market for help.  Many at the lower end of this group have come to enjoy subsidies in the marketplace.  Yet these subsidies haven’t provided enough stability for the health insurance carriers who have been leaving in masses long before Trumpcare came to be. 

Are tax breaks or incentives the answer?  No one knows for sure, perhaps “we need to pass it to see what it is”, sound familiar?

What people fail to remember about pre-ex is that is doesn’t really protect the insurance carrier, it protects the insureds.  When premiums aren’t enough to cover claims, premiums go up.  Members pay premiums, not carriers.  We need pre-ex rules as an incentive for people to pay into the system.  Insurance carriers are really no more than a bucket of money that people put their money in to cover future potential claims.  If people could reach in to that bucket at any time whether they put money in or not, the bucket would be empty.
Posted 1:55 PM

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