END OF 2018 OPEN ENROLLMENT PERIOD (Connecticut & Maryland)

Time: D H M S

Scratch Another Attack Point off the list: Obamacare ALREADY allows carriers to sell insurance ACROSS STATE LINES.

One of the many standard Republican talking points when it comes to healthcare is this old chestnut:

"Let insurance carriers sell their products across state lines!!"

I've never quite understood why this was supposed to be such a panacea, but I guess it's supposed to have something to do with "removing burdensome government regulations!" and "allowing the Invisibile Hand of the Free Market" to work it's wonders, bla bla bla. The idea is that the carriers have, until now, staked out their turf and aren't allowed to compete with each other outside of their home states; presumably, if they were allowed to do so, prices would drop accordingly due to competitive pricing, etc etc.

Well, a few days ago, Richard Simpkins brought an intersting tidbit to my attention:

As of today, states wanting to sell insurance across state lines may do so. Why isn't it bigger news, @Charles_Gaba? pic.twitter.com/HZ8YSJgDfG

— suᴉʞdɯᴉS pɹɐɥɔᴉR (@icowrich) January 1, 2016

Unfortunately, I got distracted and sort of forgot about this, but Kimberly Leonard of U.S. News & World Report is all over it today:

Buying health insurance across state lines has been proposed as an alternative to the Affordable Care Act – but it’s already in the law.

The Republican presidential front-runners, along with their trailing competitors, are all big fans of allowing Americans to buy health insurance across state lines, arguing that doing so would boost competition, resulting in lower costs and greater choice for consumers. Often, conservatives have framed such a plan as part of a replacement package for Obamacare.

The thing is, such permission is already part of President Barack Obama's health care law. 

The little-known provision, found in section 1333 of the roughly 1,000-page Affordable Care Act, allows for states to create "health care choice compacts" permitting insurers to sell policies to consumers in any state participating in the compact, as long as they follow specific rules. Five states – Georgia, Kentucky, Maine, Rhode Island and Wyoming – already have enacted interstate compact statutes, according to the National Conference of State Legislatures.

OK, so you'd think that the GOP would quit griping about this, right? Hah! That's hilarious...

The idea of buying insurance across state lines is not new. Arizona Sen. John McCain included it in his proposal for health care reform when he ran for president in 2008, and it was part of former Massachusetts Gov. Mitt Romney's plan to replace Obamacare when he ran for president in the 2012 cycle.

So it's not surprising the idea has surfaced again during this election – it's just not clear that the candidates know it's already part of Obamacare. In an August op-ed in Politico, Rubio wrote: "Americans should be able to purchase coverage across state lines so they can seek out affordable coverage regardless of where they live." In August's Fox News Republican debate, Trump said erasing state lines for insurance would result in "great plans."

Also, naturally, the GOP's version of this would actually make policies more expensive:

..."It sounds really great in concept – clear out regulatory barriers and let insurance companies market plans that can be more affordable," Corlette says. "But it's much more difficult to actually do this."  

But while Republican proposals are similar to what is permitted by the Affordable Care Act, their versions – as targeted attacks on the existing law – likely would not be subject to the same regulatory requirements already in place under its umbrella, nor those the Department of Health and Human Services is supposed to finalize.

...Democrats, meanwhile, are concerned that selling insurance across state lines would drive healthier customers to states where coverage is less expensive, leaving other states with fewer healthy customers to balance the costs incurred by those who are sick.

..."They [a fully GOP-controlled federal government] would run into considerable pushback from state regulators, however, who are not enamored with the idea of having insurers selling coverage in their state not fully subject to their oversight," [Timothy Jost] says.

To be perfectly honest, I've never quite understood this anyway, because I believe there are already "Multi-State" plans available, although that may mean something totally different given the description here. In addition, there's also plenty of large insurance carriers which operate in multiple states already, such as UnitedHealthcare, Aetna, etc. Why they can't simply offer the exact same policies in more than one state, I have no idea...and if they are doing so, how exactly does that differ from what's happening now? I guess the difference is that right now they'd have to establish some sort of official business presence in the other states first?

Anyway, this appears to be more a case of the Obama administration/Congressional Democrats trying to humor the GOP than anything else...not that it worked, of course, any more than allowing state-based exchanges (to neutralize the "States Rights!" attack point) did.