It’s hard to know what Trump administration officials were thinking when it changed federal border control rules with an executive order Friday.
Administration officials have said they wanted to surprise potential evildoers with the rule-change, in an effort to keep those malefactors from trying to rush into the United States during a transitional period. Others have suggested that the administration might have imposed a very tough version of the new rules in an effort to make a milder version stick.
Whatever the administration’s reasoning, I think the effects of the sudden change on public opinion shows why agents, brokers, employers and insurers should be encouraging federal policymakers to use an orderly, inclusive process when de-funding, changing, repealing or replacing the Affordable Care Act.
New rules governing refugees and travelers from places like Iraq affect only a relatively small number of people, and few of us know many people from those places.
New rules governing individual health insurance could affect about 20 million people, and most of us know some of those people. Some of us are those people.
It seems as if responding to a major new change in product rules takes a typical health insurer at least about 18 months.
The introduction of the Affordable Care Act major medical rules is itself an example of how difficult changing the health insurance system is. President Barack Obama signed the two bills that created the ACA in March 2010. Government officials and insurers had until Oct. 1, 2013, to get used to the new rules. But that was barely enough time for them to get the new system up and running.
The new TrumpCare system might be much simpler. But even if the federal government replaced the ACA with a federal law that tells insurers, “Do what feels good,” and prohibited states from imposing any other rules, insurers would still need time to update forms and computer systems, revive medical underwriting operations, and think deep thoughts about what claims might be like.
Agents and brokers would need some time to remember how to get clients through individual major medical underwriting.
Underwriters and consumer information services would need time to build the kinds of connections that now link the life insurers and the information services.
A system that let the nimblest insurers switch to the new system whenever they wanted, while somewhat slower insurers were still operating under the new rules, could kill off the somewhat slower insurers.
Especially in states that had relied almost entirely on the federal government to handle major medical regulation, there might be a period in which little or no individual major medical coverage would be available.