Wednesday, November 22, 2017

Obamacare Removal Transition

The first step should be to remove all penalties and allow the Obamacare participants a chance to purchase cheaper major medical plans or open medical savings accounts and allow them to cancel their overpriced Obamacare coverage.

The next step is to repeal Obamacare in its entirety to remove costly rules and regulations imposed on healthcare providers, employers and insurance companies.

These changes should allow health insurance consumers a chance to migrate off of Obamacare coverage and select cheaper coverage that may include lifetime maximums and coverage maximums and medical necessity requirements. Items covered should not be “bundled”, but should allow individually priced coverages to be chosen in a “cafeteria” fashion, so that consumers can customize the coverage they buy. The use of “annual elections” should be abandoned so that consumers can change insurance plans with a 30 day notice and they don’t have to re-assert their coverage.  If a consumer chooses a plan, it should remain “in force” until the consumer takes action to cancel the insurance or modify the coverage.

Insurance companies should have the right to establish limited rules to prevent consumers from “gaming” the system. Maternity coverage should be required to be in effect 9 months ahead of expected delivery dates.  All premiums should be based on risk and be determined by past claims like auto insurance. Those consumers who have diseases they have been treating should have the cost of those treatments added to their premium until those treatments stop.  Those consumers who have purchased “rescue and repair” major medical coverage should not be denied coverage based on their medical history so that medical and hospital bills are covered for serious illness and accidents.

There are two major groups of consumers for healthcare. One is the group who receive their coverage through their employers where premiums are based on the experience of the group.  The other group is comprised of consumers who buy “individual” policies.  Consumers who have experienced low healthcare utilization should get the lowest cost.

Hospitals should require indigent patients to secure loans to pay for treatments before they are admitted. Those patients who fail to do this should be referred to hospitals that serve indigent patients and receive charity funding.

We have already tried to base premiums on age, but that doesn’t take actual utilization into account for the 50% of the population deemed as “healthy”.  We have already tried to cost-shift costs to the young and the healthy like we did under Obamacare and that was an unacceptable disaster. Going forward, we need to base premiums on risk and for healthcare that translates to past utilization.


Norb Leahy, Dunwoody GA Tea Party Leader

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