Obama and the Slacker Mandate

In his health care rally in the Philadelphia area earlier this week, President Obama touted a proposed regulation that insurance companies would have to allow children up to age 26 on their parents’ plans – i.e. a slacker mandate – designed to appeal to the college crowd.

I wonder however, if President Obama realized the Pennsylvania already has a slacker mandate (in fact, up to age 29); state lawmakers enacted it in 2008.

In testimony to both the state House and Senate Appropriations Committees in February, Pennsylvania Insurance Commissioner Joel Ario noted that very few young adults have been enrolled under the new mandate. Ario commented, as summarized by Pennsylvania Legislative Services (subscription), that:

• The cost to insure young adults on their parents’ plan was about the same as if they bought their own plan.
• “Low-risk” young adults would buy their own plan (or remain uninsured), leaving only high-risk cases looking to the slacker mandate–and insurers were naturally unwilling to give coverage to high-risk young adults as the same rates as children.
• The failure of the slacker mandate to reduce the number of uninsured is “generally symptomatic of the greater healthcare problem.”

That is pretty much what  in the Commonwealth Foundation predicted two years ago:

SB 1453 [the slacker mandate], however, ignores the primary reason why young adults often go without insurance—the high cost of coverage. This is especially true considering that most young adults use very little health care. …

Instead of more mandates, lawmakers should adopt reforms that allow individuals to purchase low-cost, mandate-lite insurance. Another alternative would be to allow individuals to opt out or waive certain coverage mandates to reduce the cost of their insurance. … The only way to substantially reduce the cost of health care is to put individuals in charge, not government bureaucrats. This means eliminating many of Pennsylvania’s costly health insurance mandates, not adding to them. Eliminating the burden of health care mandates will lower the cost of health care, provide more insurance to more individuals, and restore personal choice to citizens.

If You Like Fraud, You’ll Like Medicaid

The Commonwealth Foundation reports that Medicaid fraud may cost Pennsylvania taxpayers up to $320 million a year.

And to think that expanding Medicaid is a centerpiece of health “reform” today.

Pennsylvania Rally for Health Care Freedom

Another state is jumping on the health care freedom bandwagon. Pennsylvania State Rep. Seth Grove (R-York) will be part of a a health care freedom rally in Harrisburg on Wednesday, January 27, at 10 a.m. The event, which will be held in the Capitol Rotunda, will be the kickoff of a move to enact a health care freedom act.

Pennsylvania Hit with $1.5 Billion Mandate

The stink over the Cornhusker Kickback can be found across the country. In Pennsylvania, for example, the requirement to raise the eligibility limit for Medicaid participation would cost the state some $1.5 billion a year, the second-highest of all states. Of course, it doesn’t get the famous bribe help that Sen. Ben Nelson procured for Nebraska.

State Attorneys General Challenge Health Care Bill

Pennsylvania Attorney General Tom Corbett is joining with a number of other state AGs (latest count is 10 attorneys general) to challenge the “Nebraska Compromise” in the latest US Senate health care bill. This compromise exempts Nebraska from the additional Medicaid costs imposed on other states, including Pennsylvania, one of the hardest-hit states. Of course, there are a number of giveaways for other states in the heath care bill – from higher Medicaid reimbursements in Massachusetts and Vermont, to exempting Florida residents from Medicare Advantage cuts, to a grant to the UConn medical center.

A number of state lawmakers have already started to push back against the federal mandates imposed on the states in the health care bills.

Richard Epstein addresses some of the other reasons “Why the Reid Bill is Unconstitutional” in a post on PointofLaw.com

Pennsylvania Hit Hard by Medicaid Mandate

The Commonwealth Foundation says that 39 states, including Pennsylvania, could be hard hit by a Medicaid mandate from Congress.

“Pennsylvania will be the second hardest hit state, behind only Texas, with an estimated $1.5 billion in additional spending. Increased taxes due to the increase in Medicaid eligibility could lead to states going bankrupt.”

In addition, Pennsylvania residents would suffer from increased federal obligations as well as higher private-insurance premiums.

State governments ration “free” cancer screenings

When you empower government to provide “free” health care (paid by others through taxes), government gets to decide when it’s appropriate for you to receive it.  Here’s yet another example from the Associated Press:

…low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society’s Cancer Action Network. In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears.

…

New York used to screen women of all ages, but this year the budget crunch has forced them to focus on those considered at highest risk and exclude women under 50….

At least 14 states cut budgets for free cancer screenings this year: Colorado, Montana, Illinois, Alabama, Minnesota, Connecticut, South Carolina, Utah, Missouri, Washington, Ohio, Massachusetts, Pennsylvania and Arkansas.

Health Reform without Tort Reform=Fail

What’s missing from health legislation trumpeted by the Democratic majority in Congress? Tort reform.

Stanley Goldfarb, associate dean of clinical education at the University of Pennsylvania School of Medicine and a nephrologist, says “cutting the cost of health care will require a real reduction in the costs associated with delivering care, not just the cost of health insurance premiums.”

One of those costs is defensive medicine.

The Commonwealth Foundation provides some commentary on this topic, too.

“In 2002 Governor Schweiker, in an effort to keep doctors from leaving Pennsylvania, signed legislation creating MCare (Medical Care Availability and Reduction of Error), a supplemental malpractice insurance program that every physician must pay into. The MCare Fund provides money for medical malpractice awards that exceed $500,000 (the amount which doctors are required to insure themselves against). But MCare simply serves as a pot of money for trial lawyers to go after, eschewing real tort reform.

States With Obama-Style Insurance More Expensive

Most Americans receive the health coverage they cherish through their employer. Chances are, if it's a large employer, it's a self-funded plan, and (as with Medicare) the insurance company is merely administering the program.

It's only smaller employers and people seeking policies in the individual market who actually buy insurance from carriers.

The individual market is where people face the most choices and have the most choice — except in those states with Obama-style regulations. People are spending their own money and so must confront directly the value of more insurance protection versus other uses of their cash. Not surprisingly, they often opt for less generous coverage with less onerous premiums.

To discover this world of choice, just go to ehealthinsurance.org. Pop in your state, age and gender, and then ponder a myriad of choices to secure protection from catastrophic health expenses, the proper function of insurance.

A 55-year-old man in Allentown, Pa., can choose from 99 plans starting as low as $141 a month for hospital coverage. A zero-deductible HMO plan costs $418 a month. Or he can pick a more flexible PPO, with a higher deductible and pay less monthly out-of-pocket for the premium.

Young people, "the invincibles," often skip insurance, because they have few assets to protect and little fear of getting sick. The congressional Democrats' solution is a tax increase by another name: Force employers to keep paying for them on their parents' expensive plans until age 26.

Yet the market has responded with products targeted at the needs of the young, such as Wellpoint's Tonik, which offers excellent protection, prescription drugs and preventive care for less than $100 a month for the under-30 set.

So if 50-somethings can get a plan at less than $200 a month and youngsters can sign up for less than $100 a month, where's the problem? Why, it's in New York and New Jersey — precisely the states that have adopted Obama-style reform — restricting insurers from charging rates based on age and preventing them from saying no due to poor health.

Change the zip code from Pennsylvania to neighboring New Jersey, and choice plummets even as the cost per plan skyrockets. In New York, our 55-year-old has only 12 plans to choose from.

The reason is simple: When people can buy fire insurance after their houses are burning, only those with a fire in the attic apply for insurance. Soon, only those who expect a blaze can afford the high premiums.

Massachusetts enacted such a system in April 2006. A CEO of a major health network reports exactly this problem: Despite the state mandate that everyone buy and keep insurance, his company is experiencing a drastic increase in people who purchase new coverage, run up big bills that are fully covered and then drop the plan.

People are simply gaming the system. Since they can acquire insurance any time, regardless of health, why pay the premium in times of good health?

This is the future of ObamaCare executed by a liberal Congress whose leaders long for a government-dominated system.

The current health-care environment offers all of the components that are touted as true reform — health co-operatives, health-insurance clearinghouses and tax subsidies for low-income Americans that ensure access to health care. But it doesn't give Washington control of reimbursement rates or health plan design, or the power to force people into insurance plans.

ObamaCare Is Bad Medicine for Pennsylvania

The Commonwealth Foundation released a new report showing that President Obama’s proposed takeover of health care by the federal government would have dramatically negative effects on Pennsylvanians.

The report, written by a research team headed by noted economist and former presidential advisor Dr. Arthur Laffer, entitled, The Prognosis for National Health Insurance: A Pennsylvania Perspective, finds that President Obama’s health care proposal would have the following effects:

• It would add $4,453 in additional health care costs for every man, woman, and child in Pennsylvania.
• Despite the additional $1 trillion in expected health care subsidies, 30 million people nationally would remain uninsured. The cost to reduce the number of uninsured by 16 million is $62,500 per person insured.
• Pennsylvania’s economic growth in 2019 compared to the baseline scenario would be reduced by 5.1 percent.

The report recommends the following reforms:

• Equalize the tax treatment of health coverage, so that individuals—not employers or government—own their health coverage.
• Repeal benefit mandates on insurers. State mandates (Pennsylvania has 52) drive up the cost of coverage. A recent study finds that each mandate results in about a 0.25% increase in the number of uninsured.
• Allow residents to purchase insurance plans approved in any of the 50 states. One estimate suggests interstate competition would reduce the number of uninsured by 25 to 33 percent.
• Repeal state laws which drive up the cost of prescription drugs, requiring higher prices than places like Wal-Mart would otherwise charge.
• Overhaul the Medicaid system, converting Medicaid spending into simple vouchers for low-income individuals to purchase their own insurance. This would improve quality, save costs to taxpayers, and reduce the price of private insurance by eliminating cost shifting.
• Adopt tort reform, eliminating frivolous lawsuits and jackpot jury awards that drive up the cost of health care.