It Has Finally Come Down to This,,,

Health insurers and supporters of the Obama administration’s healthcare reform law are currently in the midst of developing possible contingency plans just in case the U.S. Supreme Court overturns the Affordable Care Act’s (known derisively as Obamacare) individual mandate.

The insurance industry argues that premiums are likely to skyrocket without the individual mandate in place to facilitate the registration of millions of new enrollees into the marketplace as healthy people will be less likely to purchase insurance, while insurers will still be required to sell policies to all applicants. In fact, “A repeal of the individual mandate would increase insurance rates by 25 percent” according to a recent study released by none other than that venerable institution, the Robert Wood Johnson foundation. From the insurance industry itself came this observation offered up by Justine Handelman, vice-president of legislative and regulatory policy for the Blue Cross and Blue Shield Association trade group, ”The insurance reforms would have to change if the mandate were struck.”

Health insurance industry leaders say that if the individual mandate is repealed, then their first priority would be to begin the process of persuading Congress to repeal two other measures of the law; the requirement to cover everyone regardless of their medical history or pre-existing conditions, and limits on how much insurers can adjust premiums driven by age. Following that effort, the industry would then develop a rewards system for those people who purchase health insurance voluntarily and of course, sanction those who do not.

A cursive review of healthcare industry newsletters reveal other strategies the industry intends to deploy such as penalizing those who enroll outside of short annual windows, which in essence would deny treatment for specific conditions, especially immediately after a policy is purchased.

Rewarding certain insurance buyers by offering much lower premiums for younger and healthier people is another marketing strategy being considered as well as creating an expansion of the employers’ role in automatically enrolling employees for health insurance. The most dastardly policy under consideration by the industry however would be to urge credit rating firms to use health insurance status as a factor in determining an individual’s credit ratings.

The most visceral and loudest opposition to President Obama’s healthcare law comes from the political right, mostly under the banner of the Republican Party. What confuses me almost more than anything is that this law has a strong resemblance to Mitt Romney’s Massachusetts plan as it builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican opposition to attempts on the part of the Clinton administration to reform healthcare In America.

The more liberal approach to healthcare reform, one which I championed, was the single-payer approach or expressed in words that causes Republicans to faint, a National Healthcare system. This option was dealt off the table at the beginning as the White House sincerely desired to have all parties play a role in shaping what would ultimately become law.

As we all are keenly aware today however, the Republicans were simply not willing to do much in the way of compromise and honest negotiating. What they were willing to do instead, was to develop a cornucopia of sophisticated lies regarding a healthcare reform plan beginning as far back as the 2008 presidential election (remember the death panels). At least, in this effort, they truly excelled.

The logic of a universal provision for health insurance purchase is beyond reproach from anyone that understands how insurance works. Only by having individuals pay premiums while they are healthy is money available when needed to cover costs when they or others cannot. Without universal participation, the costs of health insurance rises rapidly, if it is even available for persons with less than excellent health or for those that suffer from pre-existing conditions. On its face the opposition to the universal provision is economic insanity as demonstrated by existing out of control healthcare cost increases and swelling state and county expenses for the medical care of their respective uninsured citizens.

Although the mandate has been maligned by the political right in this country, it has been upheld in two separate appeals courts, but struck down in a third. The Supreme Court hearings just ended yesterday and an official ruling is expected to be delivered in June of this year.

From the right, Glen Beck said, “What we don’t have a right to is healthcare, housing, or handouts. We don’t have those rights.”

From the left, John Kerry stated, “Great physicians and nurses, skilled, caring and unparalleled in their training, intervened in my life and probably saved it. I was lucky but other Americans are not. It is time to speak again and stand again for the ideal that in the richest nation ever on this planet, it is wrong for 41 million Americans, most of them in working families, to worry at night and wake up in the morning without the basic protection of health insurance.”

Let’s hope that the Supreme Court makes the correct decision.