If a person could remove all the platitudinous generalities about “individual choice,” and “government takeovers” Governor Romney and his supporters have slathered around with a 16″ finishing trowel, Nevada women should fine at least 4 excellent reasons to support Obamacare (the Affordable Care Act). Here’s the big four:
1. You cannot be discriminated against by the health insurance corporations because you are female. “Before the Affordable Care Act became law, insurance companies selling individual policies could deny coverage to women due to pre-existing conditions, such as cancer and having been pregnant.” [HHS] As of 2014 it will be illegal for an insurance corporation to discriminate against women because they have a “pre-existing condition,” like the ability to become pregnant.
2. You will be able to choose your own physician. “Thanks to the Affordable Care Act, all Americans joining new insurance plans have the freedom to choose from any primary care provider, OB-GYN, or pediatrician in their health plan’s network, or emergency care outside of the plan’s network, without a referral.” [HHS] This is the kind of “freedom” that has practical implications for American families.
3. You can avail yourself of preventative medicine without a co-pay. Mammograms, post-natal care, immunization for children, and other wellness treatment will be available to those joining new health plans.
4. You will pay lower health insurance costs. “Before the law, women could be charged more for individual insurance policies simply because of their gender. A 22-year-old woman could be charged 150% the premium that a 22-year-old man paid. In 2014, insurers will not be able to charge women higher premiums than they charge men. The law takes strong action to control health care costs, including helping states crack down on excessive premium increases and making sure most of your premium dollars go for your health care.”
How about the family?
5. Health insurance policies that cover children may no longer deny coverage for children (up to the age of 19) who have a pre-existing condition. If a family has a child with asthma, autism, a heart condition, etc. then the insurance corporation may not deny coverage in a family plan.
6. The emphasis is on wellness not sickness. Beginning on September 23, 2010 insurance plans must cover preventative medical services, including blood pressure and cholesterol screenings, screenings for colorectal cancer and diabetes2, and immunizations.
What does the Romney campaign have to offer? More platitudes, but some generalities that clearly indicate that the emphasis is on the insurance industry NOT the average American family. Here’s their list and a translation:
(a) End tax discrimination against the individual purchase of insurance. Sounds nice, but it doesn’t actually DO anything for American women and their families except promote the sale of individual insurance plans, as opposed to employer sponsored health insurance group coverage. This would be handy for large corporations wanting to decrease their expenses by dropping group health plans, but not so good for the 58.6% of American working families who have employer sponsored plans. [EPI]
(b) Allow consumers to purchase insurance across state lines. The insurance industry has wanted this little plum for years. It would allow the corporations to offer basic policies which cover only the medical services required by the state with the lowest standards.
(c) Unshackle HSAs by allowing funds to be used for insurance premiums. A person may already use HSA funds to pay for health insurance premiums while eligible for unemployment benefits, or to pay for COBRA premiums. Since HSAs are tax free, the young healthy and wealthy — the group benefiting the most from HSAs — would essentially get tax free health care premiums. Nice.
(d) Promote “co-insurance” products.The industry would love this one. A co-insurance product is one in which the health insurance corporation would pay “a set percentage of the covered costs after the deductible has been paid. Similar to co-pay insurance plans except co-pays require the insured to pay a set dollar amount at the time the service is rendered.” [Invest] If a person had a 80/20 co-insurance plan with a $500 deductible, then the person would pay 20% of the covered costs after the deductible has been reached or exceeded. This is essentially a shift from co-payment plans to co-insurance plans, benefiting employers who want to reduce benefit costs.
(e) Promote alternatives to “fee for service.” If you are left guessing at precisely what “alternatives” the Romney Campaign is suggesting, you aren’t alone. The campaign’s online resources don’t specify, but there are at least five models available at the moment, with the caveat that not every model is appropriate for all situations. [MinnMed]
(f) Encourage “Consumer Reports”-type ratings of alternative insurance plans. First, this doesn’t do a pigeon’s smidgen worth of good if there few, if indeed any, competitors for health policy sales in a given region. While the line sounds like “protecting” consumers, all too often private plan proposals simply reward local and regional monopolies. All the little red and black circles in the world won’t help if there is limited competition in a region. This situation isn’t a mirage:
” A 2006 study by the AMA found that health insurance is “highly concentrated” in 94 percent of the states, and in a majority of the nation’s largest metropolitan areas a single insurer controlled more than half the business. A 2007 study by Health Care for America Now found that in 38 states, the top two insurers control 57 percent or more of the market, and in 15 states one insurer controlled 60 percent or more of the market.” [CP]
A quick check this morning yielded individual health care policies available from only three companies for one county in rural northern Nevada. This really isn’t surprising since the mergers beginning in the 1980s have compressed the number of companies in the entire field.
A summation of the Romney suggestions seems to be a general preference for meeting the wants and needs of the health insurance industry, or the desires of employers to chuck group plans in favor of having individuals purchase their own in order to reduce benefit costs.
Ladies, it’s your choice: a family oriented health insurance system, or a corporate oriented health insurance system.
Desert Beacon 