Uncertainty on ACA Day 3 (exhaustion sets in)

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2 Responses

  1. Edward Hartnett says:

    I am not claiming that this is the way health insurance currently works in this country, but simply that a system very very close to the ACA could be implemented even under the challengers’ view of the commerce clause. Making everyone who purchases health care buy a long-term insurance policy would not get everyone into the risk pool, but it would get very close. Most healthy people go to the doctor at least once every few years, right? If every time a young, generally-healthy person needed an antibiotic or birth control pills, he or she had to buy a long-term insurance policy — with exactly the breadth of coverage, including preventive care, envisioned by the ACA — there would be plenty of risk pooling with plenty of healthy people in the pool lowering the average cost.

    Would it leave out some people? Sure, all those young healthy people who go years without visiting a medical professional for anything, not eyeglasses or a dental issue or an antibiotic or birth control. I just doubt that there are very many such people, or at least that there are very many such people who wouldn’t be exempt from the penalty under the existing ACA. Am I wrong about that?

  2. Nicole Huberfeld says:

    Thanks for the clarification. The method you describe, with the remaining elements of PPACA in place, would get more people into the risk pool – and yes, a number of them would still be deemed healthy (or healthy enough not to draw on the pool most of the time so that the very sick can still have benefits covered). Of course, it does not have the same ring as ‘universal coverage’ and as you say, wouldn’t achieve it either, but we would still have a larger population covered. I think, though, that the cost concerns remain real.