In 2009, the health insurance industry said “yes” to “guaranteed issue: with all Americans participating in the system, it becomes possible to ensure that everyone has coverage regardless of health status and that coverage will not be taken away. Second, access to essential benefits: consumers want to be assured that they will have a solid foundation of coverage, with the opportunity to build on that base. Third, no medical underwriting: individuals buying a policy should pay a price in line with premiums paid by others of the same age buying the same policy, with rates not determined by individual health status … ” (Ignagni, The New England Journal of Medicine, 2009).
Short version: everyone must participate or insurance doesn’t work; thus the much-maligned individual mandate that Congress has repealed beginning next year. Now Texas has challenged protections for consumers with pre-existing conditions and the Justice Department won’t defend the law as it doesn’t work without the mandate. The result will be the end of the above protections, higher premiums, larger co-pays and poor coverage.
Why wouldn’t Congress work to improve health care? Maybe because Libertarians oppose health care programs, even Medicare, and have the most money: Americans for Prosperity will contribute $400 million to the midterms, while the Republican National Committee has $250 million.
