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Fix Obamacare

First we need to realize that there is a difference between being uninsured and not being able to qualify medically for insurance. While we need to find a way to insure those, insuring six to eight million is a different strategy than insuring fifty million. I have studied what some other states did prior to the enactment of the Affordable Care Act, and I think I have found the answer.

If I were in charge of reform in this country this is what I would do. First I would keep an open enrollment period every year, however, I would make this only for the people who cannot medically qualify for insurance. I would force every insurance carrier in the stat to participate in this enrollment, but have a cap on how many they could take. I would guess about 5% of the company total number of policyholders could be in this category so once a carrier got to 5% they were closed for the open enrollment. I would also say you need to have a slight rate increase on the non healthy block of business, but have a cap of 30% of what the standard rates are. This would offset some, but not all of the medical expenses incurred by this block of business.

The rest of the business is written year round and underwritten. This will keep the rates down for two reasons, one no one is getting bombarded with the chronically ill, also you could offer a more affordable rate to the “young invincibles.” Allowing people to change plans during the year if they can pass underwriting, is beneficial as if you get a rate increase you can look around, if you have a bad experience with your carrier you can move.

The next part would be to extend HIPAA to the individual market so if you have had insurance for eighteen consecutive months, you could not be denied or rated and have the ability to change plans outside of open enrollment. That really solves a lot of issues on the uninsured market. I have always kind of believed the reason we had pre-existing conditions in the first place was due the way that part of the law was written.