Real estate Institute’s Ryan Mauro examines what happens when states set policies for their own healthcare systems.
The ACA, however, has been hailed as the most progressive healthcare plan in history.
The law requires that all Americans have health insurance, as well as requires businesses to offer coverage to all employees and covers all Americans regardless of preexisting conditions.
The ACA has created the ability for states to set their individual insurance markets, as opposed to a single national insurance plan, allowing individuals to buy coverage on their own.
With this in mind, what happens if states want to set health insurance policies for themselves?
Mauro and Dr. James Levine, an associate professor at the University of Chicago Booth School of Business, looked at the potential outcomes of states setting their own insurance policies.
“States can create their own policies that will be comparable to what is in the ACA, but there are a few limitations,” Levine told The American Heritage.
“States must first have some baseline coverage requirements, and they must also comply with the requirement that the plan must provide coverage for preventive services.
The states also must provide that coverage to the majority of Americans who need it.”
Mauros and Levine analyzed how states could set up their own private health insurance marketplaces and determine whether or not they could provide coverage to an estimated 5.7 million Americans.
States could set a number of state-based rules, such as whether a plan must cover maternity care, maternity coverage, prescription drugs, or preventative services, Levine explained.
These policies must also be consistent with federal law, such that a state can’t impose a higher cost or more restrictive coverage than the federal law requires.
States can also establish their own benchmark plans.
The benchmark plan would determine how much insurance plans would have to cover the average cost of care, as compared to what insurers offer.
But states can also set the benchmark plan, as long as the benchmark is not more expensive than the national benchmark plan.
If the benchmark isn’t cheaper than the average plan, then insurers won’t be able to sell that plan.
Additionally, states can set their benchmark plan to reflect how many people would be able access insurance, if they were enrolled in a high-risk pool.
The pool would allow people to purchase insurance from one plan or the other, depending on the health risk.
Maurow and Levine looked at how states would be compensated for the implementation of the ACA as well.
For each dollar the federal government spends on the ACA and state-administered plans, states will receive $1.50 in tax revenue.
However, states cannot get all of that money from the federal budget.
The money is used to cover uncompensated care for Medicaid and Medicare.
If a state is able to make a profit from the insurance that it plans to offer, then they can receive more money from that budget.
However, states have to maintain the same coverage that they have currently, which means they would have less money to offer to those people.
The law does provide some financial support for states that choose to implement their own plan.
States that have set up a state-run exchange can receive $10 million in federal payments over a two-year period, which can be used to help pay for outreach to people enrolled in private health plans.
States could also receive $4 million in matching funds from the government if they choose to provide health insurance to people who cannot obtain insurance through their employer.
That money can be spent to expand coverage for the uninsured, or to expand access to health insurance.
Mairos and Levy said the federal money could be used more to support outreach efforts, such a outreach to low-income individuals, or programs that help people get affordable health insurance through a tax credit.
While some people might have to adjust their coverage plans based on the new law, others could adjust their health insurance plans if they need to, Mauro said.
If states are able to expand Medicaid coverage, they could also help people pay for the cost of a new plan.
The federal government is already funding states in an effort to expand healthcare coverage for low- and moderate-income Americans, according to The Hill.