The Ohio Single Payer Act.
First, let me explain how things are, then how HB 91 would impact the way things will be. In 2014, there’ll be (basically) 2 categories of private health insurance in Ohio:
- large group insurance, offered on the open market, regulated by the Ohio Department of Insurance
- Qualified Health Plans (QHPs), offered on the Federally Facilitated Exchange (FFE), regulated by the federal government. 366,000 people will get thousands of dollars with which to buy these plans.
These two categories will have separate regulatory structures and separate markets. Large group insurance plans will be certified by Ohio, while QHPs will be certified according to federal criteria. The Ohio General Assembly can pass laws to set limitations on QHPs, but they can’t do much to affect the certification process.
They had the opportunity to take over the certification process by setting up their own exchange. To make a political statement, they abdicated their jurisdiction over QHP selection.
Enter HB 91. HB 91 basically says that no company can sell insurance on both markets.
That is, a company that issues a QHP (federal) will lose its certification to sell large group insurance (state). This would, understandably, keep the big insurance companies from offering QHPs.
And there we have the Tea Party’s plan. Nobody will sell on the exchange, and Obamacare will be ruined.
There’s a catch.
Their bill has no effect on a company that has no interest in selling large group insurance. That company (we’ll call it Hypothetical Insurance, Inc) will be guaranteed 366,000 enrollees, each of them paid thousands of dollars to pick Hypothetical. Competitors would, in fact, be illegal.
With a patient base that size, Hypothetical would be able to set their rates and demand compliance (probably in the neighborhood of Medicare, though Medicare is about 5 times larger). There would be no administrative costs (marketing is done by Navigators, enrollment is done by the federal government, reinsurance is done by the federal government).
In short, it would be Medicare for all, paid for with sharply progressive premiums.
Could Lt. Gov. Taylor refuse to certify their QHP? Perhaps, but that refusal would almost certainly violate the exchange plan submitted in February, giving the federal government the authority to certify the plan.
So, Representatives Young, Thompson, Adams, Beck, Becker, Boose, Brenner, Buchy, Butler, Gonzales, Green, Hood, Huffman, Lynch, Maag, Retherford, Roegner, Rosenberger, Scherer, Stebelton, and Wachtmann:
- Do GOP legislators have a passing familiarity with Ohio’s health care system?
- The Ohio health exchange is operational!
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