Typically profit-seeking companies try to sell products that their customers want. Not so with insurance companies when they must charge the same premium to high-risk patients as low-risk patients. Such a political control is known as “community rating.” Michael Cannon explains an unintended consequence of community rating in Massachusetts:
Massachusetts long ago adopted another feature of the Obama plan: price controls that prohibit insurers from varying premiums based on a purchaser’s health status. Those price controls further increase premiums for the young and healthy.
They also eliminate comprehensive health plans. Obama adviser David Cutler found that in Harvard University’s price-controlled health insurance exchange, “adverse selection” or the attraction of the sickest patients caused premiums for the most comprehensive plan to rise until insurers eventually canceled it. Those price controls also encourage insurers to avoid the sick. And who can blame them, considering that the government is forcing them to sell a $50,000 policy for just $10,000?
One way insurers can avoid the $50,000 patients is to drop benefits those customers find attractive. Shelby Rogers is a 12-year-old girl with spinal muscular atrophy, whose parents chose an Aetna plan through the price-controlled health insurance exchange for federal workers. Last year, Aetna announced it would drop coverage for Shelby’s 12-hour-a-day nurse, who, among other things, helps Shelby avoid bedsores by turning her over at night. An Aetna spokesman explained the reason was to avoid offering a benefit that causes the sickest patients to flock to the plan.
Over time, as mandates eliminate low-cost options and price controls eliminate comprehensive options, both the Massachusetts and Obama reforms will march consumers into a narrow range of health plans.
Read the whole article: Massachusetts’ Obama-like Reforms Increase Health Costs, Wait Times.
For references, see Providing Secure Health Insurance to American Consumers, Ref 18-21.
