REFLECTIONS

The Health Care Reform Supporters have been careful to say that you will be able to keep your health insurance under the new plan. What they have just as carefully not said is that should you lose your current insurance — perhaps by changing jobs — you will never be able to buy private health insurance again.

Fearmongering, you say? Let us look at the bill. For your reference, here is a PDF file of the bill, HR 676 (pdf), but I will excerpt the relevant sections.

This is the key portion, Sec. 104a

SEC. 104. PROHIBITION AGAINST DUPLICATING COVERAGE.

(a) IN GENERAL.-It is unlawful for a private health
insurer to sell health insurance coverage that duplicates
the benefits provided under this Act.

Well, that is all well and good, but … just what does “duplicates the benefits” mean?  Let’s see what the benefits are supposed to be (Sec. 102a)

SEC. 102. BENEFITS AND PORTABILITY.

(a) IN GENERAL.-The health care benefits under
this Act cover all medically necessary services, including
at least the following:

There are 15 items on the list, if you want to see them all go check the PDF.  However, the first five are:

1. Primary Care and Prevention
2. Inpatient Care
3. Outpatient Care
4. Emergency Care
5. Perscription Drugs

Which doesn’t really leave much not covered, does it? So … “all medically necessary services” are the benefits. And private insurers can not sell any coverage that “duplicates the benefits”.

I suppose you can get supplemental coverage for those services that are not “medically necessary”.

And since in some existing government-run plans, while pulling rotten teeth may be covered as “medically necessary”, providing a bridge so you can eat after they have been extracted is not. So there may very well be something to be gained by having such supplemental coverage … nevertheless, basic medical
insurance will no longer be sold.

So … yes, you can keep the plan you have. But you will never again be able to choose your coverage if you lose your current plan.

Is this the Change you were Hoping for?