T: Did you see this yet, John?
J: I did. It’s a really good idea; the state of Alaska has agreed to pay catastrophic claims, and therefore the main insurance carrier in Alaska changed their planned rate increase from 42 percent to 7 percent. Other states are looking at doing that as well.
Having the state – or the feds – as a backstop for catastrophic claims could go a long way towards calming the markets and dramatically reducing rate increases.
T: So Alaska is putting air bags in the system, so to speak?
J: Basically. Since Alaska is a relatively small state, just a few catastrophic claims could break the system. Having the state act as the “air bag” and pick up catastrophic claims, say over $100,000, would make it much easier for the carrier to make money – or at least not lose money – on exchange policies.
T: Has anyone from the GOP’s national leadership said anything about it yet?
J: I haven’t heard anything. I think that GOP moderates – the ones who didn’t promise to by God repeal everything Obama ever signed – would probably embrace it. It’s a realistic fix for one of Obamacare’s obvious system bugs.
T: Do you think the Alaska model can work elsewhere?
J: I think that it can. Other states are looking at it and trying to get the federal government involved, trying to get the feds to act as the air bag.
Insurance carriers love certainty. If they knew for sure that their losses on any one claim would be capped, they would feel better about offering exchange plans.
T: Will the federal GOP wonks appreciate a plan that works, or see it as a political setback, effectively ending their drive to repeal Obamacare?
J: There are a good many moderate Republicans – particularly in the Senate – who realize that kicking 24 million people off their insurance is just bad optics, not to mention bad politics. If they get their way, a properly crafted Alaska plan could pass Congress.
Whether Trump would sign it, I don’t know. It would probably depend on who talked to him last.
T: So Foghorn Leghorn will get on board. What about Yosemite Sam?
J: Well, the Tea Party Republicans will certainly look at it as a nonstarter, given that they’ve nailed their flag to beating Obamacare to death with an iron bar and roasting its rotting corpse over a fire on the Fourth of July.
T: If the general public polls in favor of the Alaska plan, at what point will the Yosemite Sams be forced to throw up their hands and accept it? Are they so at war with the Beltway that they’ll go down with the repeal ship, or will they find a way to cut their losses?
J: I think there are probably 20-30 hardcore Tea Partiers in the House who won’t be able to go back to their ruby-red districts if they vote for anything short of full repeal. The larger mass of House Republicans are sensitive to the political winds, though. If the Alaska fix gains traction in their home districts, they’ll fall in line.
They’ll drag the Sams along with them – by their hair if they have to.
T: How will the Alaska plan, if enacted at the federal level, affect a potential move towards single-payer healthcare? Is it grease, or gum?
J: I’ve always considered Obamacare to be a step on the road to single-payer. Stabilizing the ACA for the short- to intermediate-term would make it easier over the long haul to implement a Medicare or VHA expansion.
T: Do you think the current administration will get on board with expansion, or dig their heels in?
J: My money is on a lot of heel-digging. Trump promised to repeal Obamacare and he came out in favor of that fetid swamp of a Ryancare bill, so unless the Obamacare fix is wildly popular I doubt he’ll get on board.
Unless, of course, he can take credit for the fix.
T: The smart people in Congress should be able to convince the president that it was his idea, right? Like Hogan making Klink think everything was his idea.
T: Maybe that’s who Trump needs to be now – Colonel Klink. Does that make us the POWs?
J: Sure – and Trump’s base is Sgt. Schultz.
T: There is always another way to skin a stubborn cat. A little pragmatic truth goes a long way, doesn’t it?
J: It does. A stream of pragmatic truth can knock over walls a firehose full of idealistic truth can’t budge.
T: Jiu Jitzu politics.