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tv   Washington Journal Tom Wildsmith Discusses Health Insurance Sales Across...  CSPAN  March 14, 2017 12:52pm-1:02pm EDT

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compassionate leadership in driving of the congress, our nation toward better health care outcomes for them and better solutions built built on those american principles of more consumer choices, more free market but also as you said caring for the most vulnerable allowing our states innovate and medicaid in ways that will create even a better health care coverage than they have today. spirit thank you. thank you, mike. thank you everybody. thank you so much. [inaudible] >> it will get better. it will get better, much better. hopefully it will get very good. should take ip to time. [inaudible] >> thank you all. >> thank you guys.
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>> live now at the national league of cities conference will be hearing from epa minister scott pruitt on u.s. water infrastructure. the conference is held at a downtown washington d.c. hotel pick delegates invited the administrator to address the needs and financing for upgrading and approving water infrastructure and can improve community resilience. support local community economies and the national economy. we will be hearing from the administrator shortly and introductions will be made by the mayor of gary indiana. [inaudible conversations] ♪ ♪
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♪ ♪ >> you are watching the national league of cities conference there will be hearing soon from epa minister scott pruitt who has been invited today to talk about u.s. water infrastructure. things have not gotten underway yet, still doing some of the luncheon here so while we wait for the administrator to appear on the stage we'll take a look at our conversation from earlier this morning about the health care law. this is from today's washington drupal.aud. >> host: a key component of the republican health care reform effort that wasn't addressed in the bill that wasea released last week. that's the idea of sellingth health insurance across state as
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lines.s tom wildsmith is a former president of the american academy of actuaries and want to begin, what is the academy and what is its role in the healthcare debate taking place right now? >> guest: the american academy of actuaries is of the national association for actuaries practicing in the u.s. as part of our mission we do have a public policy law. we serve the public on behalf of the profession, on behalf of our members by providing nonpartisan advice on actuarial issues. to be effective in that we really had to be nonpartisan so we work with democrats and republicans. we don't take positions for orio against specific pieces of legislation, but we are very active working with the congress. in the last year we issued 14 policy papers, 22 voters guides on different issues. we submitted 87 formal comment
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letters and we had for actuaries on staff who are available whenever congressional office just wants to talk to an actuary about a technical issue. >> host: what does an actuary do? >> guest: actuaries deal with risk and the financial consequences of risk. so you see actuaries working in government agencies, with social good and medicare, projecting the future costs, which with insurance companies, setting reserves and premiums. and working with insuranceg sure regulators making sure that those premiums are fair and adequate. >> host: some special lines in this segment for the next half hour. if you get your insurance through your employer, 2,027,488,001. uninsured, (202) 748-8002. all as if it were talking about a
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specific part of the republican health care plan. president trump talking about it from his joint address in february. >> finally the time has come to give americans the freedom to purchase health insurance across state lines.[appla [applause] >> which will create a truly competitive national marketplace that will bring costs way down and provide far better care. so important. >> host: when the president talks about removingmith. restrictions on selling s insurance across state, how does he envision this working? >> guest: the idea is that if you can come insurance in some states is less expensive tha tht is in others. so that if someone in a statee where it's more expensive can purchase it from a state whereh it is less expensive, the hope
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is they would get a better deal. there are three important things to remember though. the first is that healthcare delivery is local. i live in maryland. if i become seriously ill, i'm going to use doctors and hospitals in maryland. i pretty much have to. so whatever i buy insurance from, the premiums are going to have to be based on health care costs in maryland. that's the only way it works. the second thing to remember is that modern health plans are very much based on provider networks. local networks of doctors and hospitals. i can't buy health insurance plan where all the doctors ande hospitals are in arkansas. that just won't work for me. the third thing to remember isbe that health insurance works by spreading risk and spreading costs. if health insurance plans in the state are subject to different sets of rules, that spreading of
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risk can break down and can fragment the market. so it doesn't work as well.t wo >> host: sean spicer repeater yesterday revoked complaint is about creating choice. it's a choice, a word the republicans have used this process. so you're saying taking away the lines around states, does that create more choice? >> guest: it's not going to make it much easier, seconds great as much additional choice as they seem to think, most likely. it would've been much easier third of four years ago to make this work because health insurance plans were not based on provider networks at that time. if the health insurance company is selling insurance in kansas and south dakota now, to sell insurance to me in maryland, there's a lot more that has to be done than simply erasing this prohibition against some insurance across state lines. they are going to have to create
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a physician network in maryland before they can sell insurance to me that will benefit me. so it becomes more difficult. >> host: republicans would argue under the affordable care act is people trying to buy a plan for the aca in some areas of the country if they only have one choice, in some parts of the country, not sure there will be no choices. how could this be worse than that if they allow companies to try to come up with a system that would work in another state cracks .. >> and that's a genuine
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problem. the issue of selling health insurance across state lines is just a different issue. >> selling insurance across state lines is something that is going to be happy mood and a separate piece of legislation, not this reconciliation bill that we're talking about and that the cbo scored yesterday. how much of the rating do you do on whether it has the votes to pass on capitol hill? >> i'm an actuary, not profit. i read the news like everyone else. and their major increases of health insurance medication historically have ended low. what will happen this time? >> let's do another quick poll. this time we are going to make a word cloud with the answer, i love this cloud. so the poll is, in one word, describe how you feel about being

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