COMMENTARY: New rules to ‘save’ Obamacare not what doctor ordered

Will Trinidad Navarro follow New York’s lead?

Seems the various state insurance commissioners held a convention the other week. The interesting outcome was that some of those commissioners, mostly Democrats no doubt, vowed to “save” Obamacare by enacting new rules. The new rules would be intended to frustrate President Trump’s attempts to undo some of the Affordable Care Act’s more egregious features.

Reid K. Beveridge

This isn’t about Congress’s repeal of the individual mandate. That was the feature that legally required all Americans to have health insurance. You either bought it or you paid a fine. The whole concept of the federal government stepping in and requiring all Americans to buy a product some of us might not wish to have is a mind-boggling extension of the Constitution’s Commerce Clause.

But even if you agree that all Americans should have health insurance just as most states require motorists to have auto insurance, that wasn’t the worst of it.

No, what the Affordable Care Act also provided was that the federal government could dictate exactly what those mandated insurance policies had to cover. You had no, or at least very little, choice in what you were required to buy. So you had to buy maternity coverage even if you were a male bachelor. And you have to buy contraceptive coverage even if you were a Catholic nun.

This is like the federal government telling all car owners that no longer could they buy a little cheapy buggy to get them from home to work, but they had to buy a big full-sized car with all the bells and whistles. And no more $500 junkers, either. No, siree. Only new cars are permitted for sale.

So is it any wonder that people who didn’t get their health insurance from their employer now faced a bill of $10,000 or more just for the least-expensive policies. Union folks fared the best. Their unions often negotiated the nice plans.

Nor is it any wonder that employers now faced a bill of up to 35 percent of base salary to provide health insurance and a pension for their employees.

Two points here. First, a lot of younger, healthy people didn’t want to buy health insurance at all. They told themselves that they were rarely sick, at least sick enough to need a doctor or hospital. So they simply opted out. This was both good and bad. Good for them. Bad for the system because those young, healthy and employed folks didn’t contribute premiums to the system.

When he was working on the Massachusetts system, former Gov. Mitt Romney labeled these folks “free riders.” If they got really sick, they went to the emergency room. That is by far the most expensive way to get treated for bronchitis or a sinus infection. But the ER is required by law to treat you if you show up.

A second point is that the law inexplicably prohibits selling health insurance across state lines. This means that if you quit your job in Delaware and move to Seattle, your insurance can’t follow you. You have to qualify all over again. The bad news is that if you have a chronic but treatable condition, you may be rejected for insurance in Seattle. At least insurance that will cover your condition, such as diabetes or cancer.

Back in the good old days, no more than a decade ago, some of us skirted this system with something call “catastrophic” policies. This is a policy that covers most of hospitalization or surgery. It doesn’t cover a doctor’s visit. It doesn’t cover lab work. It has a big deductible, but not — how interesting — that much bigger than some Obamacare policies so highly praised.

The purpose of this kind of insurance is to keep you from losing the house or the farm if you get really sick. That’s all it does. You have to be a smart consumer of health care. You go to the doctor when you need to, but only then. You work with your doctor on what labs you really, really need. You pay for all this on the spot.

But, of course — no surprise — Obamacare outlawed this kind of insurance. Not good enough for the American people. At least, that’s what Dr. Ezekiel Emmanuel, one of Obamacare’s authors, actually said publicly one time. He just knew that he knew better what Americans needed than those very Americans themselves.

So if you agree with Dr. Emmanuel that the government knows better what insurance you need than you do yourself, you should tell Commissioner Navarro to act now to preserve the government’s opinion.

If not, tell him to get lost.

Reid K. Beveridge has covered politics in Texas, Iowa, Wisconsin, Delaware and Washington, D.C. He is now retired at Broadkill Beach.

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