It’s true, as Marie Cocco notes in
a recent column, that Barack Obama’s health care plan wouldn’t
provide true universal coverage. Because it does not include a
mandate (except for children), it’s virtually guaranteed that some
individuals wouldn’t sign up for coverage. On the other hand, I’m
not sure how Cocco arrives at the following conclusion:
But it [Obama’s plan] still fails to recognize that
without some kind of mandate to bring everyone into the system —
either an individual mandate, like his Democratic rivals Hillary
Clinton and John Edwards proposed, or a nationwide requirement,
such as a Medicare-for-all type of system — insurance companies
still would be able to cherry-pick among those they want to insure
and those they don’t.
Obama’s plan explicitly includes a provision known as “guaranteed
issue” that doesn’t let health insurance companies turn people away
for health reasons. Here’s how his campaign website
summarizes
it:
Guaranteed eligibility. No American will be turned
away from any insurance plan because of illness or pre-existing
conditions.
Problem is, it’s not clear that guaranteed issue and other measures
which prohibit insurers from accounting individual risk factors is
really a good idea.
One
study last year found that states which had implemented both
guaranteed issue and community rating, which prohibits insurers
from taking age and gender into account, resulted in worse coverage
overall, saying that:
[S]tates that implemented guarantee issue and
community rating saw a rise in insurance premiums, a reduction of
individual insurance enrollment, and an exodus of health insurers
from the individual insurance market. In addition, the report
found no significant decrease in the uninsured population in states
that implemented these initiatives, often a stated goal of
legislators.
In other words, there’s some reason to be skeptical that the sort
of additional regulation of insurers Obama proposes will actually
provide the promised results.
