Summary
The feds are no stranger to healthcare reform. It failed under Kennedy, Nixon, and Clinton. Common sense tells us that 20% (2009) indivudual, small group AND (10%-20%) large group premium increases, and cost-shift to commercial carriers is unsustainable. Looking at federal reform now is a shot in the dark to what finally gets approved in the DC sausage maker. One thing is dangerously certain. If the healthiest commercial lives get to switch to a better rate or federal plan, it will leave the sickest people with each employer, and massively drive up experience rated premium in 1-3 years. If the the opposite happens where only the sickest people are purged from the employer plan, then the federal program will require massive new tax subsodie. There is no free lunch.
Analysis
There are proven "positions" open to the Feds as Catastrophic Risk Manager of uninsurable risk AND unpredictable medical claims loss. And they can COMMERCIALLY bid both first and second dollar risk to a hungry market, thereby preserving commercially funded health insurance, and relieving the American tax payer from funding it at the lowest cost. Lets hope for all our sakes that Obama holds his promise of not destroying commercially funded (employer paid benefits) insurance.
Key issues to be addressed in the uninsured and uninsurable market segment will entail providing an option for either entitlement add-on (Medicare, Medicare, Tricare, SSI, INS, HHS) or subsidized insurance (tax credit). The laws governing Individual and Group underwriting are very different, and the Feds do have option of offering what the private market cannot - real major medical at an affordable premium to people with preexisting conditions, or who are completely uninsurable.
