The Federalist had an article that caught my attention, The Most Popular Republican Talking Point On Health Care Is Wrong. In that article Mr. Clancy says, “Of all the various Republican health care reform ideas, the most popular by far is letting people buy health insurance across state lines.” If this is the best the Republicans can come up with I think we are pretty safe from health care reform in 2014 and at least for me, that is a good thing. Here is my comment and a graph from a previous post,

As a healthy person who buys his health insurance in Ohio I doubt that I could get a more affordable health insurance plan from another state. Every year eHealth puts out a report on health insurance prices in the 48 states they sell polices in and as long as you are not living in Massachusetts or New York the costs are pretty close. You have to admire the rich irony of this Republican talking point. The people who stand to benefit the most are from those blue states, Massachusetts and New York. I think it is pretty safe to say that selling health insurance across state lines is not going to save me money and if this is the best the Republicans can come up with then we are pretty safe from more misguided health care reforms in 2014.

The most interesting thing happening in November is that we will probably know the insurance rates for 2015 and how many healthy people are still paying into the system. Unlike auto insurance health insurance has a very large redistribution and political component to it. That is its fatal flaw. Since 1976 when I started working I have seen large group plans struggle to work around this flaw. Over the years the large group plans became increasingly more stupid about health care until we got to the present situation where we lead the world in health care spending per capita. When I look at a graph health care spending per capita by various countries, we are off the chart bad. What does the future hold for us in health care reform? Politics and government incompetence are the most important drivers. If the Administration continues to postpone the Affordable Care Act taxes and healthy people seep out of the exchanges, the exchange funding question will rear its ugly head. Although politically inconvenient I expect based on past history that the Administration will kick this can down the road and postpone most of the Affordable Care Act through 2017. This is the politically smart thing to do since the Republicans do not have much of an appetite for health care reform. For people seeking to repeal the Affordable Care Act this the next best thing but it does lead to an interesting endgame scenario. My health insurance policy is grandfathered and it costs me less than exchange plans since it does not cover maternity care and other things I have no use for. Since my insurance company does not participate in the exchange, I expect my insurance company will continue to do what ever they can to offer me the best rates to keep me from buying a plan on the exchange. This is good for me since I need affordable health insurance but bad for the exchanges since they desperately need healthy people like me. In this scenario I am best served if the Republicans and Democrats do as little as possible. Eventually the exchanges will suffer a TennCare-like funding breakdown. This is not pretty but it is the most likely scenario.