Several Republicans reportedly want to retain certain provisions in ObamaCare, not because those provisions are good policy, but because they’re popular.
The most insidious provision is the one requiring insurers to accept anyone who applies, regardless of a pre-existing medical condition, known as guaranteed issue. President Obama regularly touts this as one of the law’s signature achievements.
But Democrats figured out a problem that apparently Republican proponents have not: Requiring private sector health insurers to accept anyone encourages people to game the system by waiting until they need coverage to sign up.
That’s one reason why Democrats included the individual mandate requiring people to have coverage—which every Republican now opposes, though some liked the idea before it became such a political hot potato. The purpose of the mandate is to force people to stay in a health insurance system that’s required to accept them.
If Republicans are successful in repealing ObamaCare, or if the U.S. Supreme Court strikes it down, and they pass a guaranteed issue provision, they would do as much or more damage to the health insurance system as Democrats are doing with ObamaCare. And it’s not even necessary.
The only place where health insurers can decline an applicant is in the individual market, where individuals buy their own policies. Employer-based group coverage, covering about 165 million Americans, has been guaranteed issue for years.
And for those who are uninsured and have a medical condition, 35 states have state-based high risk pools to provide coverage. The high risk pool system needs tweaking, and some federal support would help. But there is a health insurance safety net.
However, if Republicans decide to embrace guaranteed issue just because it’s popular, they too will have to impose coercive government mandates that will drive up the cost of health insurance—just as they accuse President Obama and the Democrats of doing.