To the Editor,
Republicans plan to repeal the Affordable Care Act and replace it. If they succeed, their plan will include buying health insurance across state lines. Since that’s already law, what will change? Let’s consider two factors, premiums and appeals.
Federal law currently requires insurers to spend at least 80% to 85% of premium dollars on actual health care or quality improvement and to justify premium increases to state regulators and the Secretary of the U.S. Department of Health and Human Services.
If your insurance plan denies payment, federal law requires an appeals process – first to the plan; then to an independent review. Your exact appeal rights depend upon the State you live in, or the state from which you buy insurance, but federal requirements protect your interests.
The Republican plan most likely will eliminate any federal oversight, without which we will face a familiar situation.
In 1980, local banks issued credit cards, and state legislatures set rules and procedures, including maximum interest rates. Then the Reagan administration imposed interstate banking upon all states, including credit card issuance across state lines. Credit card issuers promptly moved to the two states with the loosest regulations; Delaware and South Dakota. Interest rates soared, and rules changed to further entrap borrowers.
The same thing can happen with health insurance. Without federal oversight, insurers can move to the two or three states with the fewest controls. Then they can return to all their old tricks; excessive premiums, appeals denials, refusing and rescinding coverage – and we will have no recourse.
Please tell your senators and representatives to improve current law, not replace it with something worse.
Note: Details of the Affordable Care Act can be found at HealthCare.gov.