Republicans' favorite healthcare 'solution' is a non-starter

by Joan McCarter

Seventeen candidates, one inoperable idea.

"What would you do if you were elected pretender?" Ask just about any Republican that question and they will tell you: Repeal Obamacare, of course. And when asked how they would solve the healthcare conundrum, a Republican's answer never varies: "Allow insurance companies to sell across state lines."
That magic solution is in every Republican plan, from the House to the Senate to scores of Republican cabal pretender candidates. And, as Margot Sanger-Katz writes: It wouldn't work. What's more, even wingnuts say it wouldn't work.

It’s such a perennial suggestion that when I called Len Nichols, a health policy professor at George Mason University and the author of a 2009 paper on the subject, to discuss the idea, he asked: “Are you kidding me? We’ve been through this about 30 decades ago.” […] The trouble with the idea is that varying or numerous state regulations aren’t the main reason insurance markets tend to be uncompetitive. Selling insurance in a new region or state takes more than just getting a license and including all the locally required benefits. It also involves setting up favorable contracts with doctors and hospitals so that your customers will be able to access health care. Establishing those networks of health care providers can be hard for new market entrants. […]
“I’ve tried for 10 years to explain this to Republicans; it is a big problem,” said Merrill Matthews, a resident scholar at the Institute for Policy Innovation, a Dallas think tank that focuses on free-market solutions to policy problems. “Just because a good affordable policy is available in another state doesn’t mean that I would be able to get the network of physicians and the good prices that are available in that other state.”

You'd think insurance companies might be tempted by the idea of finding new markets and selling in areas whose standards are more lax. But they aren't really into it. In fact, Obamacare already has a few provisions that would allow some cross-state and national expansion, while some states have also passed laws to allow out-of-state insurance sales. Outside of Medicare Advantage packages, insurance companies just aren't interested. But this ongoing reality won't stop the idea from being at the top of every Republican's list. The problem is that Republicans—especially elected ones—don't want to listen to the fact that their simple solution isn't going to cut it. That's a large part of why, in six years of talking about healthcare reform and fighting over Obamacare, its foes still haven't come up with a viable replacement plan.