Obamacare Replacement

One aspect of the plan on offer in the House is this:

…whether it includes enough reform to arrest the current death spiral in the individual insurance market.

Notably, the bill includes a new 10-year $100 billion “stability fund” that allows states to start to repair their individual insurance markets. Before ObamaCare, it wasn’t inevitable that costs would increase by 25% on average this year, or that nearly a third of US counties would become single-insurer monopolies. With better policy choices, states can make coverage cheaper and more attractive for consumers and coax insurers back into the market, and the stability fund is a powerful tool.

Right idea, but it needs a tweak.  As with all Federal transfers to the States (even though nearly all of them do not have this), this transfer needs a sunset (ideally, but not as a deal breaker, on a declining balance to the sunset date) by which the transfer will cease to exist.  States need time to adjust their budgets as their addiction to Federal money is broken, but in the end the costs a State inflicts on itself must be the sole responsibility of that State.

Then there’s this:

The larger goal is to start to restore the traditional state regulatory authority over health insurance that ObamaCare supplanted for federal control. Local governments understand local needs best. With more flexibility, autonomy and accountability, the GOP hope is that reform Governors can pry open markets and help promote a larger and more dynamic business.

The larger goal still, and an even better one, should be to reduce regulation altogether to a great degree, and let the markets regulate health insurance products and costs.

In the end, too, local governments do understand local needs better than remote Federal, and State, governments.  But the greatest understanding is even more local: the patient and his doctor.  These are the participants in a free market for health insurance products—nation-wide and freely crossing State borders—whose “regulatory” activities should prevail.

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