After SPIN! Video 12/21/14 - "Are high insurance rates because NC didn't expand Medicaid under the ACA?"
Published December 26, 2014
After SPIN! Video 12/21/14 - Question to John Hood – "It was recently revealed that North Carolina’s health insurance rates are among the highest in the country and vary greatly depending on which region of the state you live in. It appears that people in economically distressed regions, who can least afford insurance, are the ones paying the highest premiums. Is this because we didn’t expand Medicaid or establish our own health insurance networks under ACA? What’s the story here?"
December 26, 2014 at 10:19 am
Rip Arrowood says:
John just made the perfect argument *FOR* single payer health care.
December 26, 2014 at 4:50 pm
Richard Bunce says:
So residents of low cost areas could pay for the healthcare of residents of high cost areas?
December 27, 2014 at 10:57 am
Rip Arrowood says:
Isn't that how insurance works?
December 28, 2014 at 7:56 am
Richard Bunce says:
No, insurance spreads the risk of a financial loss between those who suffer the lose and those who have not (yet) suffered the lose. The premiums for each of the insured are adjusted to account for the differences in cost for the same loss. Live in a high cost area, pay higher premium.
December 26, 2014 at 11:43 am
Richard Bunce says:
While a case could be made that patients without healthcare insurance or other ability to pay showing up for treatment from providers such as hospitals that must treat them to some degree have their costs of treatment shifted across other payers. However since Medicaid reimbursements are generally the lowest of all payers having them on Medicaid may be better for hospital emergency rooms but perhaps not better over all for the fewer and fewer providers that do accept Medicaid. Had the ACA not included a minimum income requirement on the ACA premium tax credit and CSR program then low income patients would have had access to real healthcare insurance that many more providers accept and reimburse the provider for their efforts. With the tax credit and CSR expense born by the Federal government you could argue that this is cost shifting in another form and you would be correct.
