Wyoming Liberty Group

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Health insurance: options, options, (not just federal) options.

Today the Wyoming Health Benefit Exchange Steering Committee meets in Casper to continue discussing whether Wyoming should implement its own health insurance exchange or allow the federal government to implement a regional exchange that would include our state. This committee was established in the wake of the Patient Protection and Affordable Care Act (a.k.a. ObamaCare), which requires states to choose one of these two options. Exchanges are websites that will, in theory, allow people to pick among insurance policies that suit their needs and thereby encourage competition among insurance providers. However, since the available policies must all provide coverage that the federal government requires (including drug and alcohol abuse), exchanges are far from an open market.

Wyoming Liberty Group’s Regina Meena is attending this meeting, and will present our analysis of the situation. First and foremost, the fate of ObamaCare is up in the air. With cases challenging the law now pending at the Fourth, Sixth and Eleventh Circuit Courts of Appeal and inevitably heading towards the Supreme Court, it is far from certain whether ObamaCare will remain on the books.  Secondly, even assuming the worst (that ObamaCare is held to be constitutional), the U.S. Department of Health and Human Services has not released all of the regulations that will govern the exchanges. At a minimum, Wyoming should not rush to implement a program without knowing whether it is constitutional or before all of its details are available (and, if ObamaCare has proven anything, it’s that the devil is most certainly in the details).

The third and final point challenges the committee to refocus its mission. Wyoming’s options for health care reform are not limited to two kinds of exchanges. To foster true competition in insurance markets and lower costs, Wyoming should pursue interstate compacts with other states to allow the sale of the same insurance policies to a larger number of people. (Regina has written an excellent paper comparing exchanges to interstate health insurance compacts, available here.) If Wyoming’s insurance commissioner cannot accomplish this, Wyoming should consider the Georgia approach and open our borders to out-of-state policies from any other state.  Like auto insurance, life insurance and most every other kind of insurance, consumers are capable of determining their own needs, and providers respond to demand.

While ObamaCare is being challenged and implemented, it’s also already subject to major amendments by Congress in the wake of the 2010 election.  Fortunately, although the Commerce Clause is being used as a tyrannical tool to force individuals to purchase health insurance, newly proposed laws are using it for its original purpose to knock down protectionist walls between states. H.R. 371, introduced into the House of Representatives and now being considered by committee, would do just that: “Except as provided in this section, a health insurance issuer with respect to its offer, sale, rating (including medical underwriting), renewal, and issuance of individual health insurance coverage in any secondary State is exempt from any covered laws of the secondary State . . . .” So, not only is the fate of ObamaCare uncertain in the courts, but Congress is considering a freedom-friendly alternative.

Wyoming should wait and see where ObamaCare goes, and in the meantime focus on policies that will actually lower insurance costs and increase competition. The state has more than two options, and these will create options for individuals and foster true health care reform.

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Monday, 23 October 2017
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