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Independent Ideas: How to provide insurance for all

CoverColorado insures the uninsurable

Sunday, December 7, 2008

Providing health insurance for everyone who wants it doesn’t have to come with a high price tag.

It doesn’t have to come with increased government control of your medical decisions, or less personal choice when it comes to choosing physicians or deciding on medical treatments, either.

It does require is getting incentives right and letting people purchase private insurance from insurers who are allowed to experiment with different types of coverage.

In states with lightly regulated individual health insurance markets, private insurers have found new ways to offer good deals to responsible people who buy insurance before they become seriously ill.

These states also offer special plans to people who become uninsurable for reasons beyond their control.

In Colorado, CoverColorado insures the uninsurable.

In states with heavy health insurance regulation, state governments require that all private companies issue government designed policies to everyone, regardless of health status. Guaranteed issue, as this is called, has been proposed in Colorado.

Guaranteed issue penalizes responsible people. By forcing insurers to issue policies to people who are already sick, state government encourages people to put off buying health insurance until they get sick.

In states with guaranteed issue, people don't buy health insurance until they anticipate needing to pay hefty bills. After a short time, health insurance degenerates into a sickness pool, a mechanism for sharing the bills of the sick, sicker and sickest.

In lightly regulated states, health insurance plans are free to charge people a premium that covers the possibility that they may incur larger-than-normal health care costs. Excess premiums are invested against the possibility that the money will be needed for a future illness.

If you think Colorado health insurance is expensive now, take a look at the cost of joining the sickness pools in states that have passed guaranteed issue.

Brian McManus, of Medical Savings Insurance Company, compared health insurance prices in states with guaranteed issue sickness pools to those in states that still have normal individual insurance markets supplemented with special arrangements for the uninsurable.

In a heavily regulated state like Maine, a 35-year-old husband and wife with two children would pay $2,335 a month for an Anthem policy with a $1,000 deductible. In Denver, a comparable Anthem policy with a $1,500 deductible costs just $420 a month.

A 35-year-old Denver man in good health would pay $164 a month for an Anthem policy with a $1,500 deductible. An uninsurable 35-year-old Denver would pay CoverColorado $250.27 a month for a plan with a $1,500 deductible, $203.79 a month if his income is less than $50,000 a year, and $178.77 if his income is under $40,000 a year.

The same man in New Jersey, healthy or sick, would pay $2,150.44 for a plan with a $1,000 deductible. In New Jersey, the state has passed guaranteed issue, government committees tell insurers what kind of policy they can sell, and everyone gets to pay the same price.

As the numbers make clear, getting the Cover Colorado plan for covering the uninsurable is less expensive than the New Jersey guaranteed issue approach. It also does a better job of making health insurance affordable, by charging premiums that vary with household income.

Linda Gorman is the director for the Health Care Policy Center for the Independence Institute.

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