Democrats’ health insurance reform effort may be stalled, but that hasn’t stopped state legislative officials from over-reacting to the idea of requiring people to buy health insurance. Mainly Republican lawmakers in 36 states, including Tennessee, have raised the idea that a federal mandate to buy insurance could contravene citizens’ constitutional rights. And in case it doesn’t, some have proposed amending their state constitutions to explicitly forbid such a mandate.
Such objections are chiefly motivated by rank partisanship and Republicans’ sense of political opportunism, but they’ve taken off. With extreme right-wingers having whipped up a storm of inflammatory anti-reform, anti-Obama rhetoric — through groundless distortions and outright lies — lawmakers are acting as if an insurance mandates is a bad idea, one they can use to sabotage any health care reform.
It is not. It makes good sense. And coupled with the Democratic proposals to provide needed federal regulation for health insurance companies and subsidies to help middle class families buy insurance, a purchase requirement would form the backbone of secure universal care.
Under the bills stalled by Republicans, insurers would be barred from common insurance abuses, such as exclusions for pre-existing conditions, unreasonable limits on coverage, and multitiered charges for gender discrimination and health conditions. Insurers also would be required to spend more of their premium revenues on actual reimbursements, and less on the burgeoning administrative costs of claim denial divisions and exorbitant overhead for rich executive salaries.
The federal subsidies to help families purchase insurance would go, on an income-adjusted basis, to families with household incomes up to $88,000, or four-times the federal poverty limit for a family of four. People below a specified poverty level would be eligible for Medicaid.
It is strange, indeed, to argue against such needed reforms. One has to wonder why any lawmaker would object to the availability of secure, fair, affordable insurance. It’s also hard to see much difference between requiring drivers to have automobile liability insurance and requiring families to have health insurance, especially if it comes with legitimate, meaningful health insurance reforms and broad-based health care reform to reduce the actual costs of providing health care.
Currently, everyone who pays for private or employer-based insurance makes a hidden payment in their premiums, estimated at $1,000 annually, to cover health care given indigent patients in hospitals. Our income taxes also include the cost of Medicaid, which covers the very poor.
Those pro-rata costs would decline if the nation’s 50 million uninsured (the latest documented estimate) were able to purchase insurance and were not barred from doing so by pre-existing conditions and unaffordable costs.
Most of the uninsured, studies show, are adult workers, but some are young people who do not feel compelled to buy insurance because they are healthy and believe they’re generally immune to health conditions that would cost them much money. In reality, many end up receiving indigent care at public hospitals either for serious illnesses or for accidents from adventurous lifestyles (i.e., rock climbing, motorcycle and ATV accidents, and various sports injuries). Some of these accidents are catastrophic and involve hospital costs of several hundred thousand dollars.
Just as young drivers are required to carry automobile insurance, they also should be required to carry health insurance when they reach age or work circumstances that exclude them from their parents’ health insurance policies. Many parents, and many young people, would be relieved to have affordable, portable, secure insurance available to them.
Lawmakers who pander to extreme notions of unconstitutional requirements on the basis of distortions, disinformation and lies about the value or need for health care reform do every citizen an injustice — one could be extremely harmful to their health and financial security. Given the huge numbers of people forced to drop, or lose, their health insurance or benefits due to income and job losses and claim denials, that is no exaggeration.