One of the issues within healthcare reform is that of pre-existing conditions. Who wants to write an insurace policy on a house with a fire smoldering in the cellar? Unfortunately we are not talking about houses but people. Congress in it’s infinite wisdom has eliminated virtually all underwriting requirements from health insurance. That’s good for those without coverage and not so good for those with coverage because costs are going up to cover these people.
For years employers with large plans have covered all employees and all family members upon hire or shortly thereafter regardless of health, but working people have a lower risk than the general population.
The Massachuetts experience shows that by taking all comers even those who have ignored the mandate to carry insurance, costs go up from adverse selection because some people will seek insurance only when they need it…a small fire has started in the basement.
Even Medicare recognizes this risk and charges more for those who do not enroll within a specific period of eligibility.
This move by Congress does not make health care affordable. It would seem reasonable to apply some standard to all this. For example, after an initial open enrollment period, those applying for insurance for the first time would have to meet some insurability standard or pay a surcharge for their delay (just like Medicare).
Contrary to popular opinion in Washington, there is an element of personal responsibility in all this or there should be. Why should responsible Americans pay extra for those who game the system?
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