The Bronze Plan

One of the obvious ways to keep the price of a universal health insurance plan relatively modest is to water-down the definition of “insurance.” Nick Beaudrot observes that this is essentially what’s been done by Harry Reid to make the math work. The weakest form of insurance allowable inside the exchange—the so-called Bronze Plan—is not a lot of insurance. It’s essentially a “form of individual catastrophic insurance with some first-dollar coverage for certain pre-existing conditions tacked on.”

If I’m understanding the bill correctly, though, this strikes me as a pretty sensible place to compromise. Section 2713 in the general “making insurance better” title of the bill stipulates that:

A group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide coverage for and shall not impose any cost sharing requirements for—

(1) evidence-based items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force;

(2) immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved; and

(3) with respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration.

In other words, you’d be guaranteeing individuals access to an affordable plan that covers catastrophic needs and preventive needs and that they won’t be locked out of by pre-existing conditions. All three of those things strike me as extremely high-value uses of my federal dollars. Spending additional federal dollars to provide people with more comprehensive coverage also strikes me as worthwhile. But I’m a big socialist who thinks people are too averse to taxes and generally undervalue public services. The things that are in the bill—catastrophic coverage, preventive coverage, financial relief for people with pre-existing conditions—are the really tasty low-hanging fruit of health care reform. Moving to a more comprehensive posture is something I’m supportive of, but in a fiscally constrained world it’s reasonable to consider the tradeoffs between spending money on things like that and spending it on preschool or hiring more cops or building more trains or what have you.

That said, reading legislative language is hard and so I’m not totally sure that I’m interpreting this correctly as saying that even the Bronze plan needs to cover preventive services.