ACA Already Allows Cross-Border Purchase Of Insurance

Mr. President, perhaps you should first read Obamacare’s Section 1333 and related commentary to it.

Before Trump boarded Air Force One a half hour ago to fly to Indianapolis to tout his tax plan, he was further asked by the press about health care. Among his various responses, he needs to be called out on one in particular. He said he would be coming out with a major executive order that relates to Americans being able to purchase insurance across state lines. Mr. President, the Affordable Care Act already provides for that!

Section 1333 of Obamacare (ACA) enacted in March 2010 took full effect in January 2016 (“Allowing Purchases of Out-of-State Health Insurance”). It is captioned, “Provisions Relating To Offering of Plans In More than One State.” As put forth in the link, the National Conference of State Legislatures indicates that this section:

... permits states to form health care choice inter-state compacts to allow insurers to sell policies in any state participating in the compact. Two or more states may enter into compacts under which one or more insurance plans may be offered in the such states, subject to the laws and regulations of the state in which it was written.

The link goes on to scribe:

The insurer would remain subject to the market conduct, unfair trade practices, network adequacy, consumer protection, and dispute resolution standards of any state in which the insurance was sold, be licensed in each state, and notify consumers that it was not otherwise subject to the laws of this selling state. HHS would have to approve interstate insurance sales, certifying that the coverage would be as least as comprehensive as that sold through the exchange, provide coverage and cost-sharing protections at least as affordable and cover at least as many residents as coverage under Title I, and not increase the federal deficit.

As of December 2016, at least eight states have enacted what has become known as “Interstate Health Compacts,” a/k/a “Freedom Health Compacts,” which propose and authorize broader health markets outside of the ACA or other federal law (“States Pursue Health Compacts”). However, insurers have been reticent to write across state lines ― in fact, reports are that none have ― for a variety of reasons, such as issues related to establishing the delivery of in-network providers; laws governing the writing of such policies and the enforcement of its terms, i.e., where the policies are written or the residence of the insured; and the local costs associated with delivering health care (“Why Allowing Health Insurance Sales Across State Lines Won’t Help”).

As with his lack of knowledge of the contents of any of the Senate health care bills, now with Graham-Cassidy off the Senate agenda, the president now believes he has a solution to be signed through executive order. Mr. President, perhaps you should first read Obamacare’s Section 1333 and related commentary to it. You wouldn’t wish to further embarrass yourself by not knowing that federal law already provides what you intend to do by an executive order... or would you, or do you even care about (further) misleading the American public on health care?