Monday, March 29, 2010

the problem with phasing it in without thinking it through

this is the problem with going with a comprehensive health care bill that has different elements that go into effect at different times:
Mr. Obama, speaking at a health care rally in northern Virginia on March 19, said, "Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions."

The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.

To insurance companies, the language of the law is not so clear.

Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the "availability of coverage" for all until 2014.
without guaranteeing the availability of coverage, the ban on discrimination against those with pre-existing conditions is effectively meaningless. as the insurance industry has already figured out, all they have to do is refuse to issue policies to those with pre-existing conditions. voila, no discrimination against any particular condition of their policy-holders!

that's why the health care bill had to have both a ban on pre-existing discrimination and a guarantee of availability of coverage. what i don't get is why they made one part effective immediately and the other effective only after a four year wait. having the bill phase into effect might make the bill seem more reasonable to those who don't understand health care policy and it might allow you to juke the budget projections, but it means in the short term a lot of the bills provisions might not work right. and that will affect how the new system is perceived by the electorate.

this seems like a pretty stupid mistake for any politician hoping to run on the success of health care reform.