
Letter: Without individual mandate, where exactly will funding for insurance come from?
09282017 HEALTH CARE
Recently, I’ve heard candidates who in the past fought protecting pre-existing conditions medical insurance come out saying they would defend it if elected. It has become a plank in their campaign platforms and this is a step in the right direction, but I do not hear them defending other parts of national health care that must survive if insurance companies are going to provide medical insurance policies covering pre-existing conditions.

Before the Affordable Care Act, insurance companies restricted the sale of policies for people with pre-existing conditions, or they were very expensive. The policies also had lifetime limits of coverage and when someone hit that limit, they lost their insurance. They then had pre-existing conditions and found it difficult or impossible to find new coverage. This drove many people into bankruptcy.

Insurance companies are not charities, they are for-profit businesses. They will not sell a product they believe will not make a profit. No candidate can promise coverage if they create a situation where insurance companies cannot make money. If a loss is guaranteed, they simply will withdraw from that market.

This comes to the third leg of the Affordable Care Act stool. The individual mandate that required people to purchase medical insurance or pay a penalty was the method used to guarantee that insurance companies could provide medical insurance to those with pre-existing conditions without lifetime limits on coverage. Selling medical insurance to young healthy adults provided insurance companies a revenue stream that helped cover the cost of more costly policies.

Congress has killed that mandate and the open enrollment period has been reduced. If there are not enough young healthy adults purchasing coverage, medical insurance may not be profitable, and if that is the case, insurance companies will cut back on offering it. Expect most insurance to be sold as group insurance, which usually includes a cross-section of ages that provide the revenue streams to cover costs and make a profit.

When a candidate claims they will defend pre-existing conditions, they need to be asked how. If they are against the individual mandate, they need to explain where the needed funding will come from. I doubt many of them have thought that through.

Jimmy O’Neill


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