Health Care Bill Repealed!!!

Health Care Bill RepealedWith the mid-term elections upon us, could we soon see this headline in the local papers or on the cable news scroll?  Don’t bet on it. While the GOP has made “repeal and replace” their mantra during this campaign season, there are quite a few roadblocks standing in their way.  Even in some corners of the GOP they are admitting that repeal is a longshot. But for argument’s sake, let’s say that somehow the bill gets repealed and the repeal bill gets past a presidential veto.  How would repealing the health care bill affect ordinary Americans?

Well, let’s consider that a number of provisions from the bill have already taken effect.  Undoing those provisions would be felt first. Consider:

  • All of those twenty to twenty-six year olds that were allowed onto their parents’ insurance would now have to be kicked off and told to find coverage elsewhere.  How will the parents’ of those young people react to that?
  • Under the health care law, children with pre-existing conditions cannot be denied coverage.  Repeal means that the insurance companies can start denying coverage to those children again.  How will parents deal with that?
  • Any plan that started (or was re-newed) after October 1 of this year had to begin offering preventative services with no cost-sharing (no deductibles or co-pays allowed) – now they will have to reverse all of that. How will people who’ve been able to get free mammograms, physicals and colonoscopys feel about having that benefit taken away from them? Remember, this provision applies to medicare too.  How will seniors feel about the government messing with their medicare coverage?
  • Speaking of medicare, the treasury has already mailed out $250 rebate checks to seniors with Medicare Part D.  Will they be forced to return that money? How will seniors feel about the ‘donut hole’ being re-instated?
  • Fully insured health plans (after Oct 1) have built in premium increases to account for the additional services and dependents being covered.  Will they reverse these increases or will policy holders be stuck with the higher premiums even though the additional coverage has been stripped out? 
  • Most insurance companies have already reduced their commission rates for brokers going forward.  Will the carriers reverse this or will brokers be stuck with the new commission structures?
  • Finally, after the health care bill is repealed, we will still be stuck with a health care system with ever escalating costs.  What will replace it?  Are we ready for another year or two of political debate on health care reform?

So will the politicians in Congress have the intestinal fortitude to repeal the law given the above?  Maybe, but I doubt it.  “Okay,” you say, “but what about the lawsuits that the states have filed stating that the individual mandate to buy insurance is unconstituional? At least we may be able to get the individual mandate taken out.”

Most legal analysts have said this is a longshot too, but again let’s assume it happens.  The insurance companies agreed to waving pre-existing conditions for everyone in 2014 based on the individual mandate which would go into effect in 2014 as well.  Why?  Because in order to waive pre-existing conditions there must be a way to avoid adverse selection.  And the only way to avoid adverse selection is to have everyone buy insurance.  If that requirement goes, expect the insurance companies to turn around and lobby Congress to remove the pre-existing condition provision.  If Congress removes that provision, they risk alienating a large portion of the public.  If they don’t remove that provision, insurance companies will lose a lot of money and/or get of the business of health insurance altogether.   

Given the unappealing consequences of repeal for politicians, I would say that we are now on the long, bumpy road of health care reform in this country.  The best bet will be for future Congresses to tweak the bill and try to improve upon it.  How they do that will be anyone’s guess.  In the meantime, subscribe to my blog for updates.

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