I read an article this morning that kept stating the Affordable Care Act (ACA) guaranteed health insurance for everyone. Yeah, I guess it does, but you could also say that it forces health insurance on everyone (or you can pay a penalty/tax to opt out).
Look, I’m all for allowing everyone to have insurance. In fact I have a very close family member bitten by the “pre-existing condition” issue where insurance companies want to exclude a certain situation because it almost certain will be an issue again at some point in the future. That’s ridiculous.
Insurance companies (not just health insurance) are structured to get all the benefit but few risks. What happens when you don’t make any claims and the insurance company makes strong profits off you? Normally your rates increase. What happens when you do make claims and the insurance company actually has to pay money for your benefits? Guess what – your rates rise… drastically and in some cases your insurance can be canceled.
What happens though if the ACA goes fully into effect and an unintended side-effect shows up? Maybe way more currently non-insured decide to opt-out and pay the penalty. Maybe because of population age averages in different areas the cost-average benefit where needed most isn’t actually realized. What happens if everyone is allowed insurance (can’t be denied) but the rates are unsustainable? Either unreasonable or unaffordable by the individual, or perhaps the insurance company is forced into a maximum rate that guarantees they’ll lose a ton of money on that “account” (I bet they remove wording about people actually being people in insurance company documents). Guess what – if an insurance company is losing a ton of money on a certain group of accounts, you can be sure they will make that money up somewhere. Either rates across the pool will need to rise or benefits will be cut or they’ll somehow otherwise figure a way to get their money.
As stated before… I don’t have an answer. What really frustrates me though is not understanding why we haven’t already taken some baby steps in the right direction rather than such a huge change in the overall system. Why haven’t we changed the way laws and regulations are here in the USA so that insurance companies can compete more across state lines?* It seems that opening competition alone could potentially have some nice benefits. Obama said in the debate that step wouldn’t solve the problem. Maybe not, but what’s the downside of it? What wasn’t that a no-brainer first step to at least see if it would help some.
*My company provides health insurance, so other than the fact that our rates have gone crazy under the current administration (which is actually a big deal) my own and my staff’s insurance isn’t impacted much by all this. BUT, with our rates climbing at an insane pace, I wanted to get some competitive quotes to make sure we were providing the best insurance value – benefits for the given rates. What I found was that my company is very limited in who we can even get rates from because of the restrictions that exist limiting where clients (business or personal) of insurance companies can reside. So we’re locked into a “best of the worst” situation with a very small handful of options to choose from.
So… I sit and wait and watch, wondering what will happen with all this health insurance non-sense. I look at the extra money I pay annually now over several years ago and wish I could have spent that on staff (yes, it’s THAT much money). I look at family members who need to benefit from health insurance changes but with so many unknowns might actually NOT benefit when everything is enacted and running for a while. I look at the alarming pace that private practice doctors are closing their doors – putting us at the mercy of a smaller pool of providers.
I sure hope I’m wrong, but the signs so far aren’t good. I hope the impending changes don’t raise rates and hurt small businesses. I hope the people who need insurance most can afford it. I hope this all works out because it sure is a lot of work (and drama) if it doesn’t work – or even makes the current situation worse.