Congress has a shoe fetish.
The basic problem with ObamaCare – the core problem – is buried deep in the 1,994 page bill passed by the House of Representatives. More unsettling than the full price tag – $3 trillion over ten years, when fully implemented, according to the CBO – and more ridiculous than the many bureaucracies it establishes – including, no kidding, an Office of Administrative Simplification – is the commitment of Congress to better your feet.
The House would require that all health insurance cover orthotics. It’s a small idea, one easily overlooked, but it would put America’s foot – metaphorically speaking – in it.
For people with arthritics and diabetes, orthotics can be important. For others, they can bring comfort. But that single requirement suggests that ObamaCare – if finally passed by the Senate and signed into law – will raise the cost of health insurance.
And it’s just the beginning. The ObamaCare bill sets the stage for many more requirements and rules.
New Yorkers, of course, already know the problem of legislators who focus on, well, the feet first. New York State has one of the most dysfunctional health-insurance markets in the country. In 2005, a leading online insurance brokerage, eHealthInsurance, calculated the cost of a standard individual insurance policy across the nation’s 50 largest cities, comparing some 4,000 insurance plans offered by 140 companies. New York ranked as the most expensive city, its lowest premiums more than five times pricier than those of cities like Columbus and San Francisco.
Why the price tag? For years, Albany has regulated first, and asked questions later.
State lawmakers have mandated that all health plans cover a host of procedures and services. Even the most stripped-down plan must include coverage of off-label drugs, surgical second opinions, midwife services and, yes, orthotics. Each mandated benefit, of course, makes the policy more expensive. New York also demands that people pay roughly the same premium regardless of age or health status – a move that discourages younger, healthier people from buying insurance, and thus driving up premiums for those left willing to buy. Finally, the state has added billions of dollars in fees and other taxes to private insurance policies, making them even pricier still.
Since the state began aggressively regulating insurance in 1993, the number of individual-insurance policyholders has dropped by roughly 96%.
It’s not simply the cost, of course, that is so problematic with the New York approach to health reform. It’s the end result: many opt not to buy insurance in the first place. These regulations and taxes, aimed at making health insurance fair, end up making it unaffordable.
In a recent analysis, researchers Steve Parente and Tarren Bragdon look at New York State. They find that repealing regulations would lower premiums and help as many as 37% of the uninsured there to buy private, unsubsidized coverage. It would also help reserve scarce tax dollars for the poorest and sickest New Yorkers. Call it the 1992 reform: turning the clock back on more than a decade and a half of failed experimentation.
With Albany messing up health insurance, it’s no surprise that the most innovative reform has come from the Freelancers Union, which allows its tens of thousands of New York members to group together and opt out of the individual insurance market – and thus the regulation insanity.
But Congress isn’t asking why the Freelancers Union wants to walk away from the regulatory debacle. Congressmen just voted for a bill that contains all three bad New York ideas: a mechanism to regulate every health-insurance policy, a flat premium for all Americans, and a raft of new taxes.
Soon, if ObamaCare is implemented, the future of American health care will be New York. Unless, of course, the Senate sets aside these provisions in the bill passed by the House.
But the Senate leadership is on record supporting legislation that would create a committee charged with deciding what would be a “basic” health insurance policy, with unelected Washington bureaucrats having the power to add regulations – like orthotics – as they see fit without any Congressional approval. While the final Senate draft legislation will not be available for days, this much is already clear: Democrats in both the House and the Senate think health reform should include everything from the feet on up.
Americans should remember that there is no such thing as a free lunch. Or free orthotics.