The Associated Press reported Sunday some accurate, if incomplete information about Sen. Ted Cruz’s health reform proposal. “Cruz’s plan,” the story reads, “… aims to lower premiums for healthy people.” The article provided no additional details, either specifics or their presumed consequences, about his idea.
It’s true that the Cruz measure would reduce the cost of insurance for younger, relatively lower-risk consumers. His approach would allow insurers offering at least one Obamacare-compliant policy on the exchange to also sell non-Obamacare-approved coverage—coverage with higher deductibles and fewer benefits, presumably, but also a lower price tag. Such insurance is appealing to individuals who expect to face limited health costs.
Conservatives have a reason to make these plans available beyond the purpose of “lower[ing] premiums for healthy people.” Without context, this goal seems callous to the sick: the type of reasoning that fits with the oft-repeated criticism that GOP health reform proposals amount to “tax cuts for the rich.” The thinking is this: By allowing healthy people to purchase coverage that aligns with their probable needs, more of them will buy in. All else being equal, this increases overall enrollment on the exchange, and exerts downward influence on the average premium in the market.
But all else isn’t equal. Without some artificial standard for the quality of an acceptable insurance policy that applies to everyone in the market—say, an Obamacare “bronze” plan—the cost of coverage will reflect more closely an individual’s health expenses. So premiums then become steeper for the older or riskier consumers most likely to obtain Obamacare-compliant insurance. If the debate ended here, the Democratic attack that Republican health policy is “don’t get sick” would resonate more. The debate, however, doesn’t end there.
John McCormack writes (emphasis mine):
It takes a few paragraphs to set up, but Roy’s statement is integral to conservative thinking on health reform. In this instance, it refers to the more expensive subsidies for which taxpayers ultimately would pay. However, the sentence could apply just as easily to other Republican proposals this year: loosening age restrictions on what insurers could charge older consumers relative to young ones, and conditionally permitting states to opt out of certain rules imposed by Obamacare. Like Cruz’s approach, these changes would make coverage less expensive to the young and healthy, and more expensive to the old and sick or vulnerable. But both the House and Senate health bills include tens of billions of dollars to support the latter directly, through “risk pools” and “innovation funds” and all sorts of unmarketable jargon.
Read Roy’s sentence again: A fundamental difference between many on the right and the left is that the former favors “… directly subsidizing the costs of care for the poor and the sick, instead of doing it through regulation.”
This is not to say the House and Senate measures would do an adequate job of controlling the expenses of the riskiest populations. In fact, the health reform debate has moved beyond entertaining the possibility that they would: The Congressional Budget Office has been skeptical of the legislation, and no experts have testified publicly that the money made available for these pools and funds or is sufficient.
Behind any of these ideas, however, including Cruz’s, is a uniform concern: Republicans don’t want government to regulate consumers and insurers out of the marketplace. It’s a thought they’ve expressed infrequently. In the absence of doing so, the leftover column inches have done the GOP no favors.
