The insurance industry recently reiterated its support for a health insurance mandate. Since healthy folks could no longer wait until they’re sick to buy health insurance, the insurance industry has agreed to end its practice of cherry-picking the healthiest applicants and denying coverage to individuals with pre-existing conditions.
Affordability, of course, is a different issue altogether. The New York Times writeup notes, “while insurers would be required to sell insurance to any applicant, nothing would guarantee that consumers could afford it. Rate regulation promises to be a highly contentious issue, since it pits the financial interests of insurers against those of consumers.”
Most progressive proposals guarantee affordability by forcing private insurers to compete with a new government plan, limiting premium discrimination of sex and age, and ensuring that nobody spends more than a certain percentage of income (for example, 5–7.5 percent) on health insurance premiums.
As Tom Daschle, the incoming Health and Human Services Secretary, writes in his book, “the government would provide financial help on a sliding scale so nobody has to pay more than a certain percentage of their income for health insurance. Administered as a refundable tax credit, this protection would apply to employer-based health insurance as well as private insurance obtained through the pool.”
Still, the industry’s concession is significant, since some insurers remain profitable by excluding sick people from coverage. One of the biggest opponents to the individual mandate in California, for instance, was the for-profit Blue Cross plan, which found the underwriting process particularly profitable and played a major role in defeating reform efforts.
But now, the industry that brought you the infamous Harry and Louise ads of the 1990s — warning Americans that they would be forced to purchase health insurance they could not afford — may force President-elect Barack Obama (who proposed requiring insurers to cover pre-existing conditions but not creating a mandate for adults to buy insurance) to adopt a health insurance mandate! It will be up to progressives to push hard for affordability guarantees and comprehensive benefits.