The Corner

Felzenberg’s Advice

I agree with the spirit of Al Felzenberg’s advice to Republicans but not every letter of it. Republicans should not seek a new health-care bill that includes a ban on insurance companies’ charging higher prices to people with pre-existing conditions. The political paradox of pre-existing conditions is that the ban is popular but can’t be accomplished in a popular way. The ban requires all kinds of other government interventions to sustain it. For example, you have to force everyone to buy insurance: Otherwise people would wait until they got sick and buy policies knowing that the insurance companies could not turn them down or charge them extra. You have to define what insurance policies have to cover, or else that mandate can be evaded. You have to offer subsidies for people who can’t afford the insurance policies that you’ve just made more expensive. Pretty soon you’ve got Obamacare.

The solution, I think, is to address the problem of people with pre-existing conditions in a different way. My own tentative preference is for the feds to put a lot more money into states’ high-risk pools (although this would have to be carefully structured) while making tax and regulatory changes to allow the emergence of an individual market in which the problem would shrink over time. (The problem, that is, is a consequence of the way existing federal policy encourages employer-provided insurance as opposed to insurance you own and can take with you from job to job.)

Ramesh Ponnuru is a senior editor for National Review, a columnist for Bloomberg Opinion, a visiting fellow at the American Enterprise Institute, and a senior fellow at the National Review Institute.

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