Question about interstate competition amongst insurance companies...

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Example 1: Most people don't realize Blue Cross Louisiana (Francise) is separate from other states as for as policy, procedures and coverage. This helps them build a corporate shield in case of litigation. Now if I need to see a doctor in Colorado and must have XRay, Blood Test, See the Doctor and have Meds my bill could be in $2,000 range. Same goes if I break my leg skiing. The policy in Louisiana should have to help cover those expenses, right. Example 2: Here is another problem because I deal with this all the time. Inside a physicians office it's already insanely tough to 1) find if this person is insured, has Medicaid or Medicare etc 2) to know if the policy in place and if the insured has changed companies 3) Because I know and can imagine how time consuming it is all going to be dealing with various insurance companies outside the state makes me worried.

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There's so much wrong with 1 and 2 I just stopped reading.

Hope this can be an serios discussion.

My thoughts on it would be competition is good but what it could create is one small carrier after another simply vying for covered lives via a lowest quoted premium model. The idea may seem good to a consumer but the fine print of the policy would dictate - in all likelihood - huge donut holes, gaps in care or network coverage or even long claim reimbursement payouts to the networks.

If either, the patients could face unknown OOP not realized until care has been given and driving debt or default. Same idea with hospitals in terms of them not getting quick payout which could drive some service price hikes. In either case, the only winner would be the Insurance carrier(s) who are benefitting from a big infusion of out of state deposits without advancing their precious small population business model.

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Example 1: Most people don't realize Blue Cross Louisiana (Francise) is separate from other states as for as policy, procedures and coverage. This helps them build a corporate shield in case of litigation. Now if I need to see a doctor in Colorado and must have XRay, Blood Test, See the Doctor and have Meds my bill could be in $2,000 range. Same goes if I break my leg skiing. The policy in Louisiana should have to help cover those expenses, right.

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My BlueCross already does---it is simply an out of network provider. Yours does too I suspect.

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Example 2: Here is another problem because I deal with this all the time. Inside a physicians office it's already insanely tough to 1) find if this person is insured, has Medicaid or Medicare etc 2) to know if the policy in place and if the insured has changed companies 3) Because I know and can imagine how time consuming it is all going to be dealing with various insurance companies outside the state makes me worried.

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Why do you worry???? What makes it harder to send an email or make a phone call to an out of state firm?

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The number of insurance companies allowed to sell across state lines must be somewhat limited or else doctors might just reject all or most of them.

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BS. Why not? Who is going to buy insurance from a company that will not pay the doctors they want???

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You can't just have an endless exchange of companies trying to get into the state

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GOSH I hope we have hundreds. Who wouldn't??? If they can financially meet their obligations I want them. Why do you make such assumptions?

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Maybe you allow a cut off for a year and after 9 months begin reopening bids and proposals.

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Why?????

Your post is an example of the narrow thinking that our current health care system has cultivated.

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cant be done without getting rid of state standards, state controlling authorities and moving up to a national standards and control

which means more government.

but Trump has a secret plan to get it done.

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NY has high standards to protect the consumer.
Delaware is all in for the company.

I am sure that if all companies were required to come up to NY standards this idea would pass Dem Congress easily.

Many insurance companies are technically franchise conglomerates.

BCBS of California is run and managed by different folks than BCBS of Georgia. Totally different boards of directors. Totally different plan designs. Totally different costs. And totally different In-Network cost coded rating systems.

One of the big changes that will happen is to In-Network cost coding for CPT/procedural codes.

Like CPT code 64105 may be a 45 minute general physician checkup and BCBS of Georgia will pay $55 for the visit after your deductible or co-pay. But right now, that's just in Georgia and only to doctors and hospitals "In-Network".

What will happen is this "Network" will get expansion on a national level. BCBS of California will eventually be able to sell their plan in every state and Network with doctors and hospitals outside the state of California. And in doing so, they increase the competition in each state. Which, of course, equates to driving down costs.

If BCBS of California wants me to buy their policy in Georgia, they have to have lower premiums, lower co-pays, lower deductibles and out of pocket exposure, better claims handling, better customer service, and at lease the same size In-Network amount of medical providers or more than the other insurance carriers that already provide coverage in Georgia.

In turn, the carriers already in Georgia better adjust all their rates to compete with the expanse of new insurance companies entering the state.

Insurance carriers couldn't do this before because state laws prevented out of state insurance carriers from creating out of state Networks and negotiating costs for procedure codes. Right now, each state Insurance Commissioner is involved in determining procedure costs in every Network and even having final authority on what insurance companies can offer plans in their state.

Trump's new legislation will take quite a bit of power away from state Insurance Commissioners as a result of doing away with portability and state lines.

But this competition will ultimately allow insurance companies to keep costs down by nationalizing Networks of providers and by obviously increasing the number of available insurance carriers offering plans in each state.