by Mitch Kokai
Senior Political Analyst, John Locke Foundation
Last Thursday afternoon, the Trump administration released its final rule regarding Health Reimbursement Arrangements (HRAs). The 497-page document will take lawyers and employment professionals weeks to absorb and digest fully. But in a nutshell, the rule will help to make coverage more portable and affordable—while also going a long way to resolve the problem of pre-existing conditions.
As I first explained when the administration proposed this HRA rule back in October, much of the problem surrounding pre-existing conditions revolves around portability. Because most Americans don’t own their own health coverage—their employers do—when people lose their job, they lose their health coverage. The pre-existing condition problem emerges when people develop a costly medical condition while at one job, then have to switch jobs or otherwise leave their employer plan.
Solving the portability problem—allowing health coverage to go from job to job—would go a long way towards solving the pre-existing condition problem. Of course, Democrats don’t talk about solving the portability problem because they don’t want to solve it. They want the government to control everything through a single-payer health care system. That’s why they spend so much time talking about a symptom (people with pre-existing conditions who can’t get coverage) rather than the underlying disease (coverage not being portable).
But if people owned their own insurance policies, they could change jobs easily, without fear of losing their coverage. Moreover, they would get to pick the kinds of benefit designs and doctor networks they want, rather than being stuck with what their employer picks for them.