Monday, September 10, 2012

"Myth" re-redefines his position

The New York Times reported on statements made by Mr. Romney on NBC's "Meet the Press:"

I’m not getting rid of all of health care reform. There are a number of things that I like in health care reform that I’m going to put in place. One is to make sure that those with pre-existing conditions can get coverage.

I read this and surmised that he said this because he had come to understand a major cause of anxiety among the public in an employer-based health insurance market.  Without guaranteed issue provisions, i.e., protection against exclusion for pre-existing conditions, people are at risk for losing health care coverage when they change jobs or if they have not had insurance at all or during an interim period of unemployment.

I was surprised by the comment because in making it, Romney failed to mention something Governor Romney made oh-so-clear to me in a meeting in 2005, as he was advocating for the Massachusetts health reform bill.  A concomitant of guaranteed issue is the individual mandate.  If people can choose not to buy insurance until the moment they get sick, the broad risk pool of subscribers that is needed to fund insurance benefits will be harmed by a process of adverse selection, raising premiums for all.  Absent an individual mandate, a moral hazard is created that guarantees coverage to those who have decided to save money.  They then become a burden on society, being bailed out when illness strikes without having paid their actuarial share.

But almost immediately the campaign "clarified" Romney's remarks.  As reported by folks at CommonWealth Magazine, the plan he really believes in would prevent those with pre-existing conditions from being denied insurance if they have had “continuous coverage,” or if they’ve paid for insurance every month and then enroll in a new plan. It would not include people who have not had insurance at all or for an extended period of unemployment.

Ah, so he is so concerned about not having an individual mandate (something for which he argued strenuously in Massachusetts) that he cleverly proposes to restrict the restriction against denying coverage for pre-existing conditions!

No Myth.  This is absolutely clear.

No comments: