Tag Archives: 1343

Risk, Risk, Risk

1343 is an interesting section. One of the main issues with insurance to date is that, of course, insurers don’t want to have higher risk individuals in their plans. Because higher risk equals more health care expenditures equals lower profit. And you do remember that health insurance companies, for the most part, are just interested in making a profit.

So, this section provides for payments to plans that have higher than average risk profiles, and charges those plans that have lower than average risk profiles. If this were the Texas school funding system, they would call that a Robin Hood plan. The goal is, of course, to create an incentive for insurers to include both higher and lower risk people in their plans, so that the overall risk profile is the same in all plans.

We’ve reached the end of Subtitle D. How are people feeling about the topics covered so far, I wonder? We’ve talked about preexisting conditions, rate reforms, essential benefits and reinsurance. We haven’t actually gotten to the most controversial, and least liked, portion of the Act, the insurance mandates. So far, most of the changes made are things I suspect most people would probably support, if they knew about them. Not everyone, of course, but then some people don’t like rainbows, bubbles or puppies either. I’ve never known what to make of those people.

I’ll be posting another post tomorrow, starting with the next sections. Meanwhile – anything anyone wants more details on?

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