Game Night, a new movie currently showing in local theaters, includes a scene where a couple is locked in a room.  The man asks his wife for matches.  “You’re going to light a fire in a windowless room that we’re trapped in”?  He responds, “Why do you have to make my idea sound so stupid?”

There is an impulse to do something. Anything.  Action without thought.  Action without any notion of the consequences.  That may be entertaining in the movies, but it has been down right depressing in government.  We have endured eight years of Congress threatening to repeal Obamacare, the Patient Protection and Affordable Care Act.  Eight years of our elected representatives begging for matches in a locked windowless room.  Pardon me if I make their actions sound foolish and irresponsible.

Republican legislators, especially those stuck in statehouses with Washington as their goal, felt compelled to express their hatred of Obamacare whenever and wherever they could. We will ignore, for the moment, both the value and the Republican roots of the law, and focus just on the cynicism.  It was important for these men and women to report to their constituents that they were doing something.  Lucky for them, their base never really asked what they were doing or how these bills might impact the access and payment of health care.  The U.S. House of Representative passed over 60 bills that repealed all or most of the PPACA.  And those mired in the minor leagues did what they could at the state level.

And that brings us to Ohio. Thanks to term limits on the state level, our Columbus politicians rotate through the chairs at the statehouse and Washington.  A defeated U.S. Senator grabbed the State Attorney General job on his way to running for Governor.  By the way, I should probably mention that before DeWine was a Senator he was the Lieutenant Governor.  Before that, Congress.  And yes, before that, he was in the Ohio State Senate.  You know, an outsider.   So the meaningless law you promote today may be a major part of some future campaign.

As Stephen Koff reported in the Plain Dealer, Ohio has been looking at a Section 1332 Waiver since 2015 to eliminate the Individual and Employer Mandates.  As noted in August, the state expressed a real interest in applying for a Section 1332 Waiver to stabilize our market.  The stakeholders were invited to participate.  Serious people, experts in the various avenues we could pursue, invested significant time to craft a proposal.  One of the options, a reinsurance program, had real promise.  And then the plug was unceremoniously pulled.  Now?  Now we are back to a request to eliminate the Individual Mandate.

It was just last August that our Governor, John Kasich (R) and Colorado’s Governor, John Hickenlooper (D), were in Washington begging Congress to act responsibly.  They strongly promoted both the Individual Mandate and the funding for the Cost Sharing Reduction.  The Kasich administration has now officially given up.  The Republican controlled legislature has demanded the filing of the waiver on the Individual Mandate.  And though no one appears to have given any thought as to the consequences of the elimination of the mandate, or created the positive alternative that warrants the change, Ohio is searching for matches…

A quick Idaho update – As noted in my last post, Rotten Potatoes, Idaho has decided to create a parallel universe for health insurance.  Healthy individuals will be able to purchase underwritten policies that do not comply with the PPACA.  The initial offerings will have separate deductibles for name brand drugs and exclude coverage for maternity, etc.   The rates for a 45 year old may be half of a compliant contract.  And, as the healthy and those wishing to gamble migrate to these policies, the exchange policies which cover preexisting conditions and qualify for a subsidy will rise exponentially.  This is the very definition of adverse selection.

Blue Cross of Idaho is the driver of this program.  Their new policies, with fewer protections and less coverage, are called Freedom Blue.  I love naming a potentially insufficient policy that may not be fully understood until time of claim – Freedom Blue.  Because, when you think about it, freedom is just another word for nothing left to lose.


Photo – David L Cunix – Stuck on the Wrong Side of Liberty

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