The surprise du jour

I get a little ticked off that the fanning and fainting that seems to occur whenever something entirely predictable happens with respect to health care reform.  The shocking surprise du jour:

Some of the country’s most prominent health insurance companies have decided to stop offering new child-only plans, rather than comply with rules in the new health-care law that will require such plans to start accepting children with preexisting medical conditions after Sept. 23.

The companies will continue to cover children who already have child-only policies. They will also accept children with preexisting conditions in new family policies.

Yep.  Not surprised.  Nor am I going to defend the PPACA or attack the insurance companies for this.

As I’ve said consistently, the law only works (as well as it can) when all its parts are in place.  You can’t institute community ratings and guarranteed issue without a mandate.  And you can’t have a mandate without subsidies, but that’s for another post.

In a rush to score political points, the law immediately told insurance companies that they can no longer deny coverage to children with pre-existing conditions.  But, in a desire not to make the bill look too expensive or too rushed, the mandate doesn’t kick in until 2014.  So, until then, there is nothing in place to prevent parents from gaming the system.  They can wait until kids get sick and then get them coverage.

That’s bad for the insurance companies.  And, to be honest, unfair.

We could solve this in any number of ways.  You could remove the regulations until 2014 (not good for kids).  You could move the mandate up for children now (not popular).  Or you could try something else (not going to happen).

What you can’t do is pretend that this wasn’t inevitable, regardless of how you feel about the law.

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