When a Democratic congressman asked her how “volatile” the individual-insurance market was before Obamacare, Secretary Kathleen Sebelius said today in fact “it wasn’t a marketplace at all,” and was “unprotected [and] unregulated.”
She lamented that “people were really on their own,” which sounds sort of like a marketplace, but this wasn’t the case, anyway: There are thousands of pages of federal regulations already existing that applied to the individual insurance market — from the 1974 Employee Retirement Income Security Act to the Health Insurance Portability and Accountability Act of 1996, the federal government has long been closely involved in the regulation of health insurance. Much more signficantly, before Obamacare, each state set its own rules for the insurance market, which meant varying degrees of regulation. But even the most unregulated states have huge amounts of insurance rules, and even the most regulated states are having more rules added by the Affordable Care Act — see New Jersey, which had created a specific class of plans to help people find affordable coverage that’s now being banned by the ACA. Those most regulated states, of course, have the smallest and most expensive individual markets.