EDITORIAL: Repeal is easy. Replace the Affordable Care Act? That’s hard
That is a welcome change. In
Worth emphasizing is that protection for pre-existing conditions is part of an intricate layering. Establish that guarantee, and other things must follow, providing insight into why the Affordable Care Act is so complex.
The pre-existing condition pledge means higher costs for insurers. Thus, they need a hedge against risk. It comes most dramatically through the individual mandate. That brings healthier people -- and their premiums -- into play, providing the revenue stream that allows insurers to keep pace with the higher cost of covering the chronically ill.
Such complications could be avoided by, say, expanding
The past six years,
That sounds reasonable. The thinking goes that consumers would enjoy expanded choices, the reduced administrative costs and accelerated competition resulting in lower prices.
The president-elect and other
What could go wrong? Health care analysts note that several states already permit out-of-state insurance sales. There is no current federal barrier. The Affordable Care Act even encourages sales across state lines.
The problem is, insurers have shown little interest. Analysts have explained that entering another state comes with a substantial burden, especially the work involved in establishing networks of doctors and hospitals to provide care. Then, there are the difficulties in navigating the demographics, an aging
So, selling health insurance across state lines hardly rates as an elixir. Which gets back to why the Affordable Care Act is the way it is, layered and complex, borrowing from markets yet providing an essential cushion to ensure fewer are left behind.
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