Tennessee Republicans May Keep Residents from Getting Insurance on Exchanges: Are Congrats in Order?

August 24, 2016

One of the highest principles of the Republican Party is destroying Obamacare. It seems that the Republicans in Tennessee may be making a big step in that direction. According to the state’s insurance commissioner, the health care exchange in the state is on the edge of collapse. The number of insurers taking part in the exchange is down to four and the fees they charge are soaring.

That’s great news for people committed to keeping people in Tennessee from being able to get health care insurance. Of course, because of Obamacare, even if the exchange in Tennessee collapses, those who can afford to get insurance on their own will still be able to buy it in the individual market without regard to any pre-existing condition. That means that people with heart disease or cancer survivors will be able to get insurance for the same price as everyone else.

But since the subsidies for insurance are only available for people buying insurance on the exchange, if policies are not offered on the exchange, then Tennessee’s Republicans will have effectively denied the state’s citizens access to the same subsidies that people in every other state can get. Now that is a great accomplishment.

Of course it is not hard to fix the exchanges to make sure there are a substantial number of insurers offering policy. Suppose Tennessee required insurers to offer policies on the exchange as a condition of offering policies outside of the exchange.

The reason the exchanges face problems is that they are attracting a less healthy group of patients. The insurers naturally are happy to insure relatively healthy people — these people are mostly just sending the insurer a check every month. It’s the less healthy people who cause problems, they actually cost the insurers money. So, the state can just require that insurers commit to insuring less healthy people on the exchanges as a condition of insuring the more healthy people on the individual market.

That is one possible solution, there are others, if the point is to enable the people of Tennessee to buy health care insurance. But if the goal is to keep the people of Tennessee from being able to benefit from the Affordable Care Act then it sounds like the Republicans in Tennessee are doing a good job.

I suppose that’s good news for the rest of us, since we will be sending fewer of our tax dollars to Tennessee to pay for health care. I guess it means that people having trouble paying for insurance in Tennessee will have to move to a neighboring state like Kentucky, where the leadership has not been as effective in blocking people from getting health insurance.

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