As House Republicans and President Trump struggle to put together a final version of the American Health Care Act they believe can pass the chamber, the sides have re-addressed a key issue in lowering costs and creating competition: dumping Obamacare regulations requiring “essential health benefits.” What does that mean? It means that the federal government, under Obamacare, forced all health insurance plans to cover 10 areas ranging from mental health to pediatric dental health and vision, as well as maternity care. That means that men were forced to buy insurance plans that covered maternity care, making them more expensive – and also making the insurance plans idiotic, since men do not, on average, have maternity care needs.
The Left is protesting that without the federal government mandating that all plans contain such elements, people will be scammed into buying care that doesn’t cover what they need, then forced to pay out of pocket.
This is called choice.
Consumers aren’t forced to buy a certain type of food the government deems necessary – it’s their choice to do so. Consumers shouldn’t be forced to purchase a plan which includes pediatric dental care when they’re 60 years old. That’s foolish. Markets exist to provide options, not to create one-size-fits-all plans mandated by some authority from above. And if you want options for cheaper care, you need to give insurance companies more freedom to provide those options. The idea that maternity care disappears in insurance plans if the government ceases to mandate it ignores the fact that many states do mandate such provisions, and that without such a mandate, the market would seek it. There is no major insurance provider in the country that didn’t offer an option including maternity care for decades before Obamacare.
But here’s Margot Sanger-Katz of The New York Times: “Late GOP Proposal Could Mean Plans That Cover Aromatherapy but not Chemotherapy.” What’s the big problem she spots with the GOP plan? “[I]n a world in which no one has to offer maternity coverage, no insurance company wants to be the only one that offers it.” This is a legitimately moronic point. This is like saying that in a world in which no grocery store is forced to carry vegetables, nobody will. Actually, companies offer coverage where there is demand. Maternity insurance will never lack demand. Some companies will not offer maternity care because they’re not competing for young women. That’s fine. But there will be plenty of insurers that do.
Sanger-Katz later acknowledges the actual reason for this provision: it’s a back-door redistribution mechanism for charging young, healthy people more and passing those earnings along to those who are older and sicker. In the maternity context, it’s a way of making single men pay for pregnant women.
Here is a fact of life: you cannot have lower costs without competition. And you cannot have competition when the government mandates that all plans look the same. If your goal is competition and lowering costs and increasing availability of health insurance for the most people, repealing regulations is the best solution. If all you care about is cramming down expensive health insurance on everybody, driving down health care quality, creating shortages in the medical profession – all at public cost – you may as well nationalize the care. The hodgepodge that is Obamacare simply doesn’t achieve what it supposedly sets out to achieve.