Monday, November 18, 2013

Part Deux Point Une: Now You Get To Keep Your Plan?


Part Deux Point Une: Now You Get To Keep Your Plan?

What do you think is a viable solution to this mess?
Mike was asked to respond to this question.

Mike Walker, Col. USMC (retired)


This time there is no easy fix. The Republican bill just passed in the House is not a solution either.

First, many state insurance commissioners are not allowing the dead plans to come back to life. 

Why? 

Primarily because killing the old plans was designed to get those people to enter their exchanges. If they go back to the Zombie plan then the State exchanges may go broke. Secondly, it is a one year fix and then you are right back where you started, might as well suck up the pain now and get it over with.

Even if the State commissioner says it is OK then it still may be impossible. The cancelled plans fit along a continuum. 

If the insurance company still has a very similar plan in the exact same market then it may be able to offer the Zombie in a short period of time and hope the pool of souls returns to make it financially sustainable for one year.

However, if the company left the market, say your core business was in the Bay Area and Northern California and you dropped out of the San Diego area (i.e. you ended your relationship with the local doctors, clinics, labs, pharmacies, hospitals, etc) then trying to bring back that Zombie plan to San Diego for one year is realistically impossible.

If a company is somewhere in the middle, then time is the big enemy. In other words, you can do it but not immediately. 

An analogy could be cooking the Thanksgiving turkey and you have 30 minutes with an oven that heats up to 550 degrees.

If you bird was already stuffed and precooked then you may be in business in 30 minutes, if the bird is a big frozen block just bought at the store then you will fail.

Mike