tv Washington Journal Joseph Antos and Sabrina Corlette Discuss ACA... CSPAN August 2, 2017 1:38pm-2:34pm EDT
pacific northwest. his book is "fighting for dreams that mattered." >> we were screaming at that counsel. you want to get on the other side of that bench. you are going to have to calm down. i got that from whites and blacks. attitude,o change my because i really didn't realize other side ofhe the bench, makes the law. >> sunday at 2:00 p.m. eastern on american history tv, we will hear a tacoma bridge to about its collapse into the puget sound in 1940. it was considered the third suspension bridge in the world, and it is now used by civil engineers as a study in bridge design >>. design.
>> there was an unfamiliarity with just how it big thing like this was supposed to behave. so people excited about it, there was a certain musical, kind of gracefulness, about a bridge like this. so people, i guess, just wanted to think there without anything wrong. >> these programs and more as c-span's cities tour brings you to tacoma, washington, saturday at noon eastern on c-span2's book tv, and on c-span2, american history tv. -- and on c-span3. visiting cities across the country, the c-span cities tour. andhe white house reefing schedule just under one hour from now, 2:30 p.m. eastern time. when a gets underway, you can see it live here on c-span. and sheldon, a conversation on insurance markets under the affordable care act -- until then, a conversation on insurance markets under the affordable care act. host: joining us to talk about
health care, repeal or replace, or whatever might be happening on capitol hill, we have two guests. sabrina corlette from the georgetown university center on health insurance reforms. antos fromh aei, american enterprise institute. thank you for joining us. we start with news that the chairman of the health committee announced he will hold hearings beginning in september. we're talking now about bipartisan legislation, possibly, and the goal would be to stabilize and strengthen the individual health insurance market for 2018. let's start there, sabrina. what is your sense of the conditions right now? guest: i think there is a lot of desk consensus on what is needed to shore up the marketplaces. going into 2017, there was a lot
of evidence, financial and otherwise, that insurance companies were starting to find their footing after a few rock y years. but the policy uncertainty coming out of washington, the debate over whether they would repeal the aca or not, whether there would be an individual mandate, all of that uncertainty is causing insurance companies to be nervous about their long-term participation. so i think, going forward, the condition of the markets is that we don't know, because there are still key decisions that need to come out of washington to give insurers the confidence they need tuesday in the market. want to get your thoughts, but first, that announcement that sabrina mentioned. what is the white house considering right now? they have decisions to make about money being put into the
system. guest: right, the biggest decision is whether they commit to making monthly payments to insurance companies to compensate them for what are called -- their cost-sharing reductions, which basically means instead of paying a six -- paying a $6,000 deductible, your deductible might be much lower, $500, $1000. that is big money. that is $7 billion over a year. so this is something that really matters, but it is also a matter of great debate, because of course, congress never appropriated the money. there is a real argument now within the administration. republicans argued for four or five years that the money should not be spent. they are now in charge and a faced with whether they spend it or not. host: phone numbers on the
bottom of this grant for our guests. hereve a separate line that we want to point out. let me start over, because we have two lines we are doing through this segment. if you are insured through the aca, call 202-748-8000. all others call 202-748-8001. again, 202-748-8000 if you are insured through the aca. , that second line, is for all others. we will get to your calls in a couple minutes. projections to help paint a picture of what is happening out there with those exchanges. 40y wrote, in july, that counties are projected to have no insurers next year. 1332 counties, over 40% of counties, nationwide would have only one issuer. at least 28,000 people are currently enrolled for health
country -- coverage are on the exchanges and live in those counties. sabrina, more on the state of the country. guest: sure, and those numbers are a little bit out of date or just yesterday, i believe, there was an announcement in ohio that said all but one county will be covered next year. so it is a lot fewer counties than what the trump administration projected a matter month ago. that said, i think, as joe pointed out, this issue about the subsidies to reimburse insurers for these low-cost sharing plans, that is a critical decision. so we could either see a lot more counties without a participating carrier if they learned that they will not be paid back for those expenses or we could see every county covered if they get some certainty about that. that is the decision everyone is on the edge of their seats for.
guest: one reason why we have good news from ohio is states are not helpless in this regard. states can make some changes within current law without any changes from congress to, shall we say, encourage and possibly worse -- possibly coerse insurers to stay in some of the counties. in particular, one of the best techniques is to combine reaching -- rating areas. in a state, you may have a city, a suburb, a rural area. often times, those are different locations as far as what the premiums are going to be and whether an insurer has to be there. the state can say, ok, now we going to combine them, combine the suburbs with a rural area, for example. that broadens the risk pool and brings in more people. that gives a shot, at least, at a market that an insurer could
potentially see as a long run possibility. host: let's hear from chuck schumer, senate minority leader was on the floor yesterday talking about the president and what he sees as cutting these cost-sharing payments. [video clip] >> the american people are looking to congress to turn the page on health care and start working on bipartisan improvements to our health care system. stabilizing the individual market is the first thing we should all focus on. the repeated attempts to repeal and replace the health care law, as well as the administration's threat to stop making cautionary -- making the cost-sharing payments it helped keep premiums down and markets stable, has injected massive uncertainty into the system. insurers hate nothing more than uncertainty. it drives them to jack up the costs of premiums and to pull out of markets. host: let's hear from our guests. joseph antos.
guest: it is true that insurers do not like uncertainty. insurance is supposed to take care of risk, which is the irony. you know, it is a little late. it is really great to hear that senators want to hold hearings in september. but this is a problem that could have been resolved at the beginning of the year. since insurers have to make up their minds finally one way or the other by the end of september, it does not give much of a chance to react too good news or bad news. what is their fix? the fix is going to be to increase premiums. it does not mean they will necessarily drop out of the market but it will mean that , taxpayers will pay a lot more money for the same thing. host: sabrina corlette. guest: i agree with joe. i think that insurers are going to respond to this kind of
uncertainty, including the subsidies, with premium increases. if you get a subsidy through the affordable care act marketplace based on your income, you should be insulated to some degree from premium increases because you're subsidy will rise to compensate that. but if you are not subsidized, you will bear the full brunt of could bee hike, and it steep in a number of places. host: let's go to calls. we have the two lines here. if you are insured through the aca, call 202-748-8000. all others, 202-748-8001. we have george coming up first hear from elk ridge, maryland. you have insurance through the aca, correct? caller: that is correct. ok, one thing i want to point the insurance is concerned, we never had a big problem until the trade deals came out, and it took all of these people out of the system.
when these companies folded up. they sought to get their business done someplace else. the other thing is, it is quite obvious that our congress and senators are supporting the insurance companies versus supporting the american people. it is time to go to a medicare for all. stop paying the insurance companies all this money. stop and go to a system where we can pay directly to a medicare system. take the money you were just talking about paying these insurance companies, and put that into medicare for all. let's do the right thing for americans here. there are all these countries that have medicare for all for
their countries and their citizens, and they pay half the cost of what we pay in the united states. let's stop all this mingling and bull crapping, and let's do the right things for americans. stop giving insurance companies the money. put it in a fund that provides for coverage for everybody in the united states. and let's do the right thing. host: let's start with sabrina corlette. there are a number of countries in europe and canada and elsewhere that have largely government-run health care systems. they have pros and cons. the medicaid for all idea has been put forward in congress before. it has never, at least to date, it has not garnered much political support from either
party, frankly. i think that dynamic could change a little bit if you see the individual markets collapsing and insurers pulling out. you could see a pendulum switch shift in the political calculus where more and more democrats could start to call for a single-payer system. of course, with any health care system, the devil is in the details. while certainly a single-payer system could simplify things and ensure that health care is a basic right for all americans, there could be issues in terms of provider participation in and making sure people have access to care and services that could be more limited. there are pros and cons with every approach and winners and losers. two date, the medicare for all concept has not had a lot of political support here. down asngle-payer going
an amendment in the senate late last week. guest: there is good reason it does not have much political support. senior citizens tend to be the most active voters in the country. as president trump and virtually every other president who has ever held the office has said, we're going to protect the medicare program. partly because it is a relatively sound program and partly because of the politics. we are talking about people who have a lot of sway at the polls. george makes another good point. that is really at the heart of the matter. you have to start from where you are. and where we used to be was a dominant employer-sponsored coverage system. whether you blame it on trade deals are just changes in technology, changes in the way the economy operates, whatever the reason, it is true lower income people used to have good
jobs. they may not have those jobs and may not be able to get coverage through their employers, and i think that is the major source of angst over health insurance and overall in the country. jim in connecticut has insurance through the aca. caller: good morning. what has your experience been like? caller: extremely positive. the connecticut exchange is well -run, well-managed with limited choice, but good choice. there are two insurance companies in the aca and connecticut. one of them bullied it was going to drop out of the system, but they changed their minds for some reason. there are two providers and connecticut. i receive my coverage through anthem blue cross, a bronze .lan
i pay a premium but i receive subsidies. my comment is the areas in the country where there is only one , theder or no provider state regulators should demand that if they do not provide coverage in certain counties, they should became to out of the state and not provide coverage to anyone in the state. if that becomes the case, the citizens of those areas should receive a government-sponsored program. the other thing is that the individual mandate needs to be enforced in order for this good law to take affect. right now, there is not any strict enforcement of the penalty needs to be a lot stricter than $100 on your tax return. it should be something that becomes a penalty for not getting insurance. the young people and healthy people need to be encouraged and almost bullied into getting insurance for themselves, because only the old or the sick , just stating the facts, if only the old or the sick are in will go upthe rates
and insurance companies will demand more money for providing coverage. host: thanks for calling. let's hear from sabrina corlette as we look at a map illustrating what we talked about in terms of the number of carriers around the country. the darkest green indicates counties that have three or more carriers. the lighter the green gets, the fewer carriers. when you see the brown-tan col or, that is one carrier in a county. red means guest: your caller is zero. very well-and formed. i have two points in response to his comment. one, i think he is absolutely right that states have a lot of power to encourage or compel insurance companies to participate. california is an example of a state that told carriers, look,
if you are not going to participate, we are going to bar you for a couple years if you ever want to come back. so it was an incentive for carriers to participate. the other point about the individual mandate, and the caller might be one of the few people who supports it, but it is a powerful incentive for healthy and young people to enroll and be part of the risk pool. and insurers have said, without it, it will drive premiums up as much as 20%. guest: you know, that is one approach, but there are other ways to solve this basic problem. what the aca did was to establish a new social norm to say that regardless of your health condition, you should be able to buy health insurance without exclusions are higher premiums. if you want to do that, that is a good decision. it is a social norm. but if you are going to do that, it means you bring into insurance people with high costs.
one possible solution is to bring in young people, overcharge them, hope they do not understand they are being overcharged for something they really do not want -- they are young -- and hope they stay in the system. the other approach is what a lot of people have talked about, a combination of high risk pools or reinsurance, basically a money issue, not an enrollment issue. you have to get the money to the insurers to provide this e services. the mandate did not really work very well. we ought to be looking at other approaches. host: a caller from mount hope, idaho. you are on. caller: hi, yeah, there was a gentleman -- can you hear me? host: go ahead. caller:.
providers. i have been with them for almost 40 years. i just now started to use them. it is in saying, the paperwork. they tell me which drugs i can use now. they tell me which doctors. i never had to get preapproval on half the stuff. i don't get any kickbacks. my co-pays have gone up. the medicine -- i drove in to pick up my diabetic shots that i am paying $25 for, and she goes, that will be $240. i just got the notice a couple of days ago. we have an open season, and they wait until after the open season so you cannot change your carrier. and they actually have no pride, no shame. thet down with one of bookkeepers because i wanted to see what everything was for major surgery. i had been overcharged almost 10% of what my bill was, and she just came right out and said you , i am sorry,
host: thanks. guest: this is a common problem for people who have had good health insurance for a long time. they need more prescription drugs. federal employees have a generous subsidy similar to the kinds of subsidies all large companies seem to get for the health insurance. there are assurances as the lady suggested. you cannot find out what the circumstances would be but you have to be aggressive. you have to be an aggressive shopper. that is true in the medicare program and the fedor -- federal employees program. it is true for the employees program as well. if you are not on your toes,
you'll spend a lot more money than you thought. >> your caller mentioned she is a retired federal employee. she said she is also paying a lot for health insurance despite really generous coverage. president trump has made jabs that congress for their generous health care benefits. both members of congress and federal employees have the essentially the equivalent of employer coverage. the government kicks in about 70% and change. that is less than average. most large employers kick and above 80%. it is on par with what people are getting with employer sponsored coverage. an important one she mentioned was one of the providers, you
have to help pick up the cost for uninsured folks. that is an issue when providers have to treat and take care of uninsured people. they often get left paying the cost and providing that service. and they pass the cost on to the rest of us who have coverage. it does increase our cost when you have people who are uninsured. host: an opinion page, a lead editorial. if the president was to govern by twitter threat, the recent suggestion that members of congress should have to live under the health care law they impose on americans. perhaps they will be inspired to fix the law for millions. taylor is on the line. insurance through the aca. go ahead.
caller: it is funny you said that. it is one of my main concerns. i am paying the money but you have people in congress who do not have the same rules as me. what is it mean for my family and for me? that they may pay them -- pay less money. think of at how much money they're making than the average person. someone like me works three jobs but you have people who sit at the office all day long and try to determine what is best for me and my family. you do not live by the same rules as i do on a daily basis. how can you make the accusations and assumptions about what people need when you do not have to live by -- with regular
people. you have the resources. i don't have that. you have guaranteed health care until you leave your job and even when you retire, the health care program still benefits you. when i leave my job, i have to find health care elsewhere. you talk about how this is a market, it is not a market. you give us a bunch of bad choice and you say here, pick from these choices him whatever you get, you get. that is how we failed the american people, especially those who live in impoverished communities and who cannot afford much. working paycheck to paycheck every day. it is a shame i have to work three jobs just to support my family. as your average american does not make that much, that is the reality i live in. so my comment is why don't we
live under the same guidelines as people in congress? why is it not equal. host: that is my concern. we do understand the point. let's hear from our guests. guest: people have multiple jobs and are concerned about future. it reflects the state of the economy, the state of progress in the economy. when technology changes,, -- good jobs before, they lose their jobs and they get caught in the grinding of the economic system. that is largely unrelated to whether people with employer-sponsored coverage have insurance or not. members of congress and their
staff and federal employees operate under the same rules that a majority of americans operate. what he is really complaining about is the affordable care act did not provide him the kind of coverage or low-cost that he who was promised. that is true. he did not get what he expects. guest: i completely agree with joe on this but the other thing to point out is, and it is not so much what congress has but people who haven't -- employer-sponsored coverage, but those with had to buy insurance on their own directly from an insurer, there is a huge advantage that everyone who has employer-sponsored coverage benefits from. the employer's contribution to your premium as well as your
contribution to your premium, it is actually the biggest tax subsidy in our tax code. when you are buying on your own, you get no tax a vanished. it is a safe disparity and it is one for political reasons may never be addressed. it is really about people with employer coverage. host: lead story -- seeking increases as high as 30% in 2018 under the affordable care act. iowa, wyoming, seeking to raise premiums by 30% or higher. major market players in new mexico, tennessee, hawaii, indicated they are looking for
averages of about 20%. big figures. >> and not surprising. it goes back to the $7 million. insurers have to make up for it in some way. of course we have inflation and health care. it tends to run much faster, probably five or 6% cost growth and health care we obviously cannot continue this way forever. that is a large part of the problem. your reductions have probably gone for 10 or 15%. host: let's hear from paul in maine -- paul in maine. caller: this does not directly affect me because i am retired from law enforcement i have
great coverage. also, the v.a.. because what the aca has sent to my mother in her 80's, her insurance went up like this -- 60%. my sister and husband are in a different state. we only have one insurer in the state. i do not recall her name, sorry, i see the aca -- my family suffering terribly -- terribly.
i do not understand what either one of you are talking about. i'm independent. host: thank you for calling. sabrina corlette is -- works with the center on health insurance reforms project. guest: i think paul is speaking to challenges families face regardless of the source of coverage. i'm guessing his mother if she is 80 years old is on medicare. what people are experiencing is we have had in -- an incredible rise in health care costs. it predates the aca. we see higher prices from providers as more technology has come online.
people are experiencing, as the prices go up, they have to bear an ever greater brunt of the costs. their israel pain because incomes have not grown at the same level. that is something the caller is reflecting. it would probably be true regardless of whether the aca was enacted or not. it cannot adequately address these rising health care costs. host: sean gets insurance through the aca. first, explain your experience with the program so far. caller: i have been in it since the beginning. i have been a graduate student at the university here and i
signed up for the aca because i did not have insurance through my part-time employer. i have had positive and negative. i had to file an extension for my taxes, which was a pain. the other thing is enrolling every year. i auto enrolled. i get notices saying my premiums are going up. i usually find the same deductible and co-pay. i just have to look for it. the good side is i get a physical every year i do not have to pay for and i am healthy. your health is wealth. it depends on what you want to invest in it. guest: he is doing the right thing. the system forces you to look
around every year. if you should do that. that is correct. the obama administration regularly had the message. it is a good message for everybody and not just people in the aca. guest: and i'll the caller stays enrolled. host: the washington post reminds us the court ruling, federal or repeal court tuesday, that could help reserve a key subsidy that benefits millions. the attorneys general want to preserve the subsidies in the repeal of the lawsuit. on behalf of about 7 million low income people. democratic attorney general of
new york along with california, the motion of the court granted in its most recent, gnarled and legal political history of these subsidies. in practical terms, the result can make it more difficult for the trump administration and house republicans who abandoned that without a court fight. what you think? guest: i think states are right. there are serious consequences to the insurance market and to residents if these subsidies are cut off. they were right to try to intervene in the litigation and ultimately, i hope over the long, subsidies can continue. they are important to the health and stability of the markets and consumers who rely on them. host: they read about lawmakers getting together on health care,
40 house and republican democrats want a slate of obamacare fixes this week. it is tom reed, who has been on the program. what does this mean to you? >> they are supporting want the insurance industry and many, sabrina and i, for example, have said they will have to deal with. the various aspects, they are obviously talking about reductions, it is too much money to say it is not insurers. that it will not work. they talk about the stability fund, another name for what is probably a high cost risk death risk pool. the ideas to put money into the system to cover the exceptional cost of people of serious health
conditions who may not have been insured previously. they are talking about other adjustments meant to you -- appeal to republicans. they would change the employer mandate sewn that of requiring all employers to offer coverage, raise that to 500. that is a sticking point and i am not sure it is a major real issue but it is ticking, a political point. they are willing to repeal the tax, 2.3% tax. this is probably more of a political issue than not. they are talking about letting states experiment more with insurance markets. basically talking about this provision in the aca, making that more accessible.
finally, they will be able to do that without it -- without spending additional money. if they could do that, they might get a hearing. >> what is interesting is what is not in it. there are important priorities republicans had that are not in it. the individual mandate that everyone loves to hate is not repealed or modified in this proposal. and they do not address key insurance reforms like a benefit mandates in the affordable care act. the requirements around pre-existing conditions productions and limits on how much you can charge an older person versus a younger person. those were all in the crosshairs going into this session of congress and they are not even mentioned. host: it is a good reason for
that. it is meant to be bipartisan. a good bipartisan solution makes everybody a little unhappy. guest: that is right. i think it reflects a record -- the recognition that you need to protect people pre-existing conditions. that seems to be a line on both sides that we need to do. there is a recognition that you need something to give healthy people an incentive to enroll. host: good morning to you are on. caller: good morning. there is one aspect of the discussion i am terribly confused about and i hope your guest could shed light on it. there has been a notion of allowing insurance companies to repeat -- competing -- across insurance lines. i do not understand, if it would
help to bring costs down, why would anyone oppose this? if you could clarify what is going on, i don't understand why it would have to be a part of a large and comprehensive bill. it is something congress could do as a standalone. guest: didn't probably would not bring a lot down one of the biggest cost is provider cost. it will not travel to another state to get health services. you will get those locally, where you live. that is a big driver of why premiums cost with a cost. a big reason people are concerned is one way it could result in lowering costs is if you allow insurance companies to go to a low regulation state, a
state that does not have a lot of benefit mandates or does not regulate pre-existing condition protections, and fell into a state that does, you can end up with the money from playing field. companies in that state have to play by the rules and have to offer comprehensive and if it's. cannot deny people covers with pre-existing conditions and a group of insurance companies can bypass all of that. healthy people lou -- moved to the low regulation market, and people are stuck with higher premiums in the more regulated market. most state officials will say we want to be able to protect the residents of the state paired we want insurance companies to be accountable to us. that is how it is been since 1945. that is another concern. you need to have someone to go to. he will not be a will to go to
wyoming if you live in delaware and say please help me out. collects large insurance companies operate across stateline -- state lines. entities reflect the market conditions and utilization and pricing conditions in the local state markets. they are effectively already there. sabrina is correct and for any of this to really go forward, republicans have to get the authority to change the insurance market rules. host: larry from richmond, virginia. caller: i was just listening to what the other caller was saying. i live in richmond, virginia. when he spoke about republicans,
if you notice, we do not even apply for the aca in virginia. we have to go straight to the marketplace. my wife is a counselor. -- a cancer survivor. we used insurances through her job. she got sick and we had applied to several companies to pay it on our own. i think the create -- i think the creator upstairs for the affordable care act. had it not been for it, we would not have insurance that i'm 63 years old. it has in -- because we live in north carolina, he was so opposed, he wanted to get it. north carolina effectively, with
the legislature, the generals humbly, it is overwhelmingly republican, and pushed it out. it is a gridlock. these republicans, it is all about the lobbyist, the big-money insurance companies, and i think what the president is trying to do is terrible. host: thank you for calling us. guest: i think he is talking about whether the state expanded medicaid eligibility or not. i know virginia did not. it is chu that many states did expand medicaid eligibility. they did it because the obama administration bribed them. they offered them 100% funding, a good bribed. some states, especially southern states, virginia being one of
them, decided for put a recent and also looking toward a long-term perspective of having to pay money for people in their states, and being worried about the state fiscal situation, it does not make any sense to me really. that we have states using federal dollars to subsidize medicaid coverage for people well above the poverty line in other cities are not covering people who are well below the poverty line. i understand the issue about states rights but i think we need to rethink the issue. caller: i want to talk to you people because i love you guys. you do an awesome job.
the thing is republicans have been putting uncertainty on the insurance companies themselves for the past six, or seven years possibly. the insurance industry now is a whole is making a lot of profit. a lot of investment is going on. i watched the stock market also. here's the thing. pre-obamacare, pre-obamacare, as the republicans want to call it, the affordable care act, they announced they were raising new rates that year 50% for the next year.
this was before the affordable care act was even enacted under president obama. host: and the question for our guest? while we have you? caller: yes. [indiscernible] excuse me, i retired in january. i started receiving my retirement benefits in march. why did they keep it that you can only apply once a year? guest: i think what he is her for a to is the fact that the affordable care act, there is an open enrollment time and this will go from november 1 two's
december 15. that is the window you have to buy coverage. if you leave your job or move to a new state or you have other life events, it can get a special enrollment but for people in the normal course of events, the window of time is open enrollment. that is to prevent people from waiting until they are in the emergency room to call up the insurance company and sign up for coverage. caller: thank you for taking my call. a lot of people are calling in to say insurance, desire making so much money and the horrible insurance companies. what do you think will happen when the government is going to
run all the scrap? -- this crap? who will pay for all the new doctors we will need to cover everybody who will cut their finger. when my kids were small, i went to the local hospital and they had services. i got all my kids immunized for free. it is ridiculous. can we do health care like laser surgery? i surgery? when it first came out, it was like $12,000. you can now get it for free. it was not covered by insurance. and marketplace worked and people brought the cost down. there are simple things but the government will not do it because they want control of it. there are a lot of solutions without the government.
host: tim is in baltimore and has insurance under the aca. caller: i would like to make three quick comments. number one, single-payer is a joke. $20 trillion in debt. we cannot currently pay for all the entitlements we pay -- we promised already. number two was medicare. a total bribed and the states that collected into that, there is no money for it. the reason insurance companies -- the government bribed them to go on. they said luck, you in this plan the first few years, we will guarantee you a 2% profits. if they cannot make a profit, they are out. last thing i want to say is i
will give you a good example, i've been in the insurance business for four years. i saw this as the greatest thing since sliced bread. the government said to me when obamacare was passed, tell usthe government said to me, tell us what your income is. if it is a low income, we will subsidize you. knowing how the government operates, there is no way they will catch me if i have low income. i have the best insurance you can imagine. i have no deductible. my premiums are highly subsidize. i should probably be paying $1700 a month. i probably pay $700. i have no deductible. if i had put down my regular income, my deductible would have been $12,000 for my wife and i. if the government catches me, let's say they get smart and catch me two or three years from now, do you know what the penalty is?
$500. so let -- it is $2500. so let them catch me. they can't send me a bill for $2500. what they have done is given me an advance tax credit. they say you shouldn't have gotten that tax credit. your income is not what you told us it was. the only way they can get it is to take it out of my tax refund. calling.nk you for we have time for a final thought from our guests. guest: the question of whether the insurance -- the individual market is stable, will it be beyond, i 2018 and think the reality is that it will be. it's because of federal dollars. unless there is major change in the law, insurance companies will begin nt -- will be
guaranteed increasing payments, regardless of how much of the costs go up. in a few counties, where there aren't many people, that will always be a problem. but that was always a problem anyway.but in most of this country, you can make a business out of that because there is a guarantee of payment. that is precisely the reason why we need to reform the system. there is no real break on the increasing costs. guest: i would agree with joe on all of his points. i would just say i'm not quite as send when that the market will be stable long-term. the federal dollars will shore it up. things that insurance companies need, for better or for worse, we decided to deliver a public entitlement through private companies any to make a profit. they also need a trusted,
reliable government partner that isn't going to change the rules on them in the middle of the road, after they have set their prices. i think they need to see some signals from this administration that they are going to be that reliable government partner and that they are in it for the long term. host: we have time for one more call. lexington, kentucky. caller: thank you for taking my call. there's been no discussion on and whying drug prices they are such a no-no. today, io is listening highly recommend a book "an american sickness" by elisabeth rosenthal. excellent. she kind of goes to the history of how this insurance and health care