Critical Condition

Lunch with Nancy Pelosi; More on the “Slacker Mandate”

Interesting news to report from my lunch with Nancy Pelosi at San Francisco’s Mark Hopkins Hotel. A few hundred of her closest friends convened to hear the speaker field a handful of soft-ball questions from the Commonwealth Club’s president and CEO.

Most of Mrs. Pelosi’s remarks concerned the immediate “benefits” of the health-care reform. Unsurprisingly, the biggest cheers went up for the “slacker mandate,” whereby health plans must enroll beneficiaries’ “children” up to age 26. Because this provision does not require those “children” to maintain continuous coverage, the “benefit” will be the first trigger of a <a href="http://www.john-goodman-blog.com/a-private-health-insurance-death-spiral-will-begin-on-september-23/-9897″>death spiral for private health insurance. This is because only the sickest twenty-somethings will seek to enrol in their parents’ plans, once this provision kicks in on September 23.

(Here would be a good place for me to apologize for and correct an error in my previous post, wherein I wrote that the “slacker mandate” went into effect immediately. This provision comes into force six months after enactment.)

Perhaps a little concerned that even her San Francisco audience might understand this bad incentive, Mrs. Pelosi said that “children” could only take advantage of this “benefit” if their parents agreed. Perhaps this is to compensate for the obvious incoherence of a law that compels a parent to provide coverage to a ”child” many years after a parent is free to expel his offspring from the family home and otherwise cease paying his living expenses.

Unfortunately, the law does not grant parental choice over this benefit, despite Mrs. Pelosi’s claim. H.R. 3490 § 2417(a) states:

In General — A group health plan and a health insurance issuer offering group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child (who is not married) until the child turns 26 years of age. Nothing in this section shall require a health plan or a health insurance issuer described in the preceding sentence to make coverage available for a child of a child receiving dependent coverage.

There’s nothing here that remotely gives parents the power to nullify this provision. I predict that the first lawsuits over Obamacare will not be constitutional, but instead over “children” who want to get coverage on their parents’ health plans but whose parents don’t want them there!

I should also note that the president’s March 30 signature on the Reconciliation Act amends the previously signed law to allow married “children” to take advantage of this option [H.R. 4872 § 2301(b)], thereby making this problem even worse.

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