Felicia Muftic — GOP offers bait and switch health care
It is human nature to dislike being mandated to do anything, so Republicans think they have a hot platform they can run on in this summer and fall. Their pitch: “Your freedoms are under attack. Repeal and Replace Obamacare.”
Not only are they fudging the truth about any attack on your freedoms, their Repeal and Replace is bait and switch advertising. Their bait: Freedom from individual mandates. Their switch is to replace it with an alternative that is nowhere near an equivalent. Their replacement would leave out the key popular consumer protection provisions in the new law and it would not make insurance affordable or accessible to most who do not have insurance now.
Even Republicans give lip service to the advantages of protecting consumers from being denied insurance because of pre-existing conditions or having insurance dropped on the sick or demanding high deductibles that bankrupt you. However, mandates and universal coverage are what make consumer protections affordable and possible.
For private insurers to keep premiums reasonable and to cover those with pre-exisiting conditions or the sick, they must have a very large pool … a group that contains those who pay in but do not place many claims as well as those who place large amount of claims. Averaging costs of claims is the key. In the past, insurers have cherry picked only those healthy enough to work and who have large group employer provided insurance and either refused to cover the rest or charged them very high premiums. That is the main reason why so many in our country do not have insurance.
The mandate requires you in four years to have insurance if you do not have insurance through your employer or on your own. (Those insured by Medicaid, Medicare, veterans benefits, or are covered by parents’ insurance are not affected by mandates). Even if you are required to buy health insurance and if you cannot afford it, there will be a government subsidy based on your income. This makes it possible for the pool to be large enough.
There is a fatal flaw in the Republican’s “replace” pitch. The savings they plan to generate by selling unregulated insurance across state lines or reducing your ability to sue for malpractice is not enough to offset the costs of the consumer protection or make health insurance affordable to any more than 3 million of the 31 million who are uncovered now. Not only that, the Republican replacement would reduce the hit on the federal deficit by only half as much as “Obamacare.” (Their replacement plans were scored by Congress’ own budget office.) To claim otherwise is just plain false advertising. Instead you will hear Republicans hem and haw vaguely with: “We’ll reduce the cost of insurance.”
There are those who mistakenly believe that you are mandated to buy the government run market of private insurers plans (popularly called the exchange); You are not. You are free to buy insurance from any company.
Will you go to jail, pay a fine or subject yourselves to IRS snooping if you do not comply? No. You will be subject to fines if you fail to get insurance, but the final version of the reform law removed the penalties for not paying the fine. Whether so many will take advantage of this loophole that it will make the pool too small is possible. Experience with a similar Massachusetts plan is that few freeload but the CBO projects 4 million might. Those 4 million could burden our ERs and cut into anticipated savings.
There are other mandates, though. Insurance companies and large employers are mandated to provide insurance that include those consumer protections. Insurers will be required to devote 80 percent of the premiums paid to them toward actual coverage. Maybe those are the mandates Republicans want to free us from. Nah. Surely not.
– Felicia Muftic is author of the “Colorado Consumer Handbook”; visit http://www.mufticforum.com for more on health care reform.
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