The Corner

Politics & Policy

A Health-Care Mystery

NR’s editorial on the House Republican bill to modify Obamacare goes into some of the flaws of one of its provisions:

It eliminates Obamacare’s fines on people who go without insurance, but in their place creates a new [30 percent] surcharge for people who let their insurance lapse and then try to purchase a new policy. The goal is to keep healthy people from leaving the insurance rolls and thus destabilizing insurance markets.

The surcharge is a heavy-handed instrument: Insurers would be obligated to impose it regardless of their preferences. Yet the surcharge might not achieve its goal. A lot of healthy people might well decide to go without insurance and run the risk of paying a surcharge if they get sick later. The surcharge even undermines its own goal, since it would discourage healthy people who had already left the insurance rolls from getting back on them.

The editorial also explains that fear of a filibuster has done a lot to shape the bill. Senate rules make it easier to avoid filibusters for provisions affecting spending and taxes than for provisions affecting regulations. That is one reason Republicans decided not to take on Obamacare’s regulation requiring insurers to treat sick and healthy people alike–a regulation that requires the individual mandate or some substitute for it to be in place if insurance markets are to function. (This particular regulation is also popular, which surely influenced the Republicans’ decision as well.)

What’s a little puzzling, though, is that the surcharge itself is a regulation. The government wouldn’t be charging people extra for letting their coverage lapse and then buying a new policy. It would be ordering insurers to follow that practice. So why wouldn’t this regulatory change be just as subject to a filibuster as all the regulatory changes Republicans are refusing to try to make?

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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