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The Tangles We Create When We Mandate



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The White House is scrambling to explain yet another significant change in the implementation of Obamacare: This time the accommodation is an expansion of the law’s “hardship exemption” to include people whose plans have been canceled, meaning those individuals don’t have to buy standard Obamacare plans in 2014. They can buy “catastrophic” plans instead.

They were against it before they were for it: Prominent Democrats — including the president — are on record opposing a mandate-driven health-care system. But they couldn’t get to single payer, or even a “public option,” so they adopted some “Republican” ideas, added more mandates, and got Obamacare.

Then Democrats told us everyone needed comprehensive coverage — bronze, silver, gold, or platinum. But now, apparently, some people don’t. Peeling back mandates sounds like a free-market idea . . . but doing so only for certain groups of people, well, that’s more like the Obama administration we know.

If only “catastrophic” meant “catastrophic,” and “insurance” meant “insurance.” But nothing means anything anymore. The plans now open to canceled Americans are very similar to bronze plans, even requiring the same minimum essential health benefits as other plans.

The law originally intended these plans for people in their twenties, and insurance companies have been working (and setting premiums) with that information. Now that some older people are allowed into the “catastrophic” pools, it’s no exclusive young-adult swim, so to speak. But insurers should be used to the adjustments now, after the keep-it-if-you-can “fix” for plans that weren’t grandfathered.

And if things don’t work out, no worries, that’s what the “risk corridor” payouts are for. Remember when Democrats demonized insurance companies? Now they just scratch their backs.

But the idea of more health-care freedom is in fact a good idea. Let’s go further, and take away all coverage mandates, for all people. This would force insurance companies — not government PR contracts — to sell their products. Let’s let individuals decide which catastrophes they’d like to insure against (instead of presuming, for instance, that everyone thinks of maternity as a calamitous event).

If this latest change is a “common-sense clarification,” as HHS spokesman Joanne Peters said, then by extension all Americans should be given this same opportunity to buy bare-bones coverage. If it’s good for 4 million people, why not 310 million? We should all get a hardship exemption from Obamacare.

— Hadley Heath is a senior policy analyst at the Independent Women’s Forum.



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