- - Friday, July 14, 2017


Will Mitch McConnell allow true consumer freedom when it comes to health care, or is he only using the language of consumer freedom as a bait-and-switch to provide cover just long enough to cobble together the 50 votes needed to pass his health care reform bill?

That’s the question smart conservatives are asking themselves after looking at the language of the revised health care bill he released on Thursday.

Let’s back up: ObamaCare took the costs of covering people with high health insurance expenses (think: older, sicker, those with pre-existing conditions) and socialized that cost by spreading it over another, larger group of people - people who buy their insurance in the individual market, who would now have to pay much higher prices for their own health insurance. The result, predictably, has been skyrocketing premium prices and worse health care in the individual market.

The problem is, even that larger group isn’t really a very large group of people at all. According to a September 2016 report by the U.S. Census Bureau, just over 16 percent of the population gets its insurance in the individual market.

Is it really fair to ask that small group of people to bear the burden for the rest of us?

Sens. Ted Cruz and Mike Lee don’t think so. They reasoned that if we, as a society, have made the decision to pay for high-cost health insurance patients, then it’s only fair that we, as a society - meaning, taxpayers - should all bear that burden together. So, lift the burden from those in the individual market, and put it on taxpayers, where it belongs. Create a separate risk pool for high-cost patients, and subsidize that directly, from general revenues, while you let those in the individual market once again purchase plans relieved of ObamaCare regulations, which will sell for less, in a separate risk pool.

Weeks ago, they began pushing their Republican colleagues to support their “Consumer Freedom” amendment as a means to lowering premium prices in the individual market. The amendment essentially says that any insurance carrier that offers at least one ObamaCare-compliant plan can also offer plans that do not comply with ObamaCare’s stringent regulations. That would allow insurance companies to offer plans that don’t meet ObamaCare’s stringent “essential health benefits” requirements, and would allow insurance companies to price their premiums without regard to “community rating” requirements - which would translate into lower premium prices for younger, healthier people who aren’t expected to consume as much health care.

Many conservatives - who have, by and large, been disappointed by the bill’s failure to repeal much of ObamaCare’s infrastructure (particularly and precisely its failure to overturn ObamaCare’s mandates on insurance companies) - believed that the Cruz-Lee “Consumer Freedom” amendment would make support for the bill palatable.

So Sen. McConnell, trying to shore up his right flank, acceded and added language very similar to the Consumer Freedom amendment. Except there’s a hitch: His language requires that even if insurance companies begin selling non-compliant plans, they nevertheless can have only one risk pool, which will include all their customers, regardless of whether they bought compliant plans or non-compliant plans.

That defeats the purpose of allowing the creation and selling of non-compliant plans. If the prices don’t come down - and they won’t, because they’re not escaping the risk pool that includes high-cost patients - why would anyone buy a non-compliant plan in the first place?

If there’s only one risk pool, there’s no true consumer freedom.

After seven long years of working to pressure Congress to repeal ObamaCare, it comes down to this - will a Republican Senate continue to allow the burden of paying for those with high insurance costs to fall on the relatively small percentage of Americans who get their health insurance in the individual market, or will a Republican Senate take that burden off their backs and place it on the backs of a much larger group - American taxpayers?

If a Republican-controlled Senate can’t even get that right, we’re in trouble.

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