Excerpt from NYT editorial 11-28-16. What will happen if President-elect Donald Trump and Republicans in Congress carry out their pledge to repeal the Affordable Care Act, the 2010 health reform law? By most estimates, up to 22 million people, many of them poor or older Americans, will lose their health insurance. Mr. Trump seems to recognize this would be disastrous — to an extent.
Since the election, he has said that he wants to keep the part of the law that prohibits insurance companies from discriminating against people with pre-existing conditions. Without this provision, insurers can deny those customers coverage, charge them exorbitant rates or refuse to cover treatment for those conditions.
Lets face it, if Obamacare was truly working there would be no people with a pre-existing condition because they would have been insured years ago.
That aside, if you prevent insurance companies from charging risk appropriate premiums (exorbitant as the Times ridiculously claims), the costs don’t go away, they are simply allocated over the entire insured population driving up premiums for everyone.
If you do as Paul Ryan suggests; set up high risk insurance pools (which were in place in some states prior to Obamacare), you accomplish nothing except create a quickly unaffordable group of insured individuals.
There is nothing you can do to lower premiums if the insured pool includes individuals with high cost health care claims. You can play games, shift costs, isolate them, etc. but if individuals are allowed in any way to avoid paying premiums until they are certain they will collect more in benefits, you lose, period.
Insurance, any insurance, works because among those who pay premiums are individuals who have large claims, small claims, moderate claims and absolutely no claims (a group I highly desire to be in for all my insurance). Any attempt to ignore that merely demonstrates the ignorance of the effort.
The idea that free choice and free markets work for health care is bunk.
If the freedom not to carry health insurance is all that important, let those people provide a guarantee, perhaps a bond or lean on their assets, that they will not seek dollars from society for any health care they receive. 😜
If this sounds like an argument for some form of universal coverage, maybe it is. Maybe that answer is that if you choose not to buy the insurance you want, you are enrolled in a separate Medicare pool and that costs of that pool are taken from your pay in the form of a special payroll tax. Don’t like that; then show responsibility and carry insurance like the majority of Americans.