Boehner Asks: “Why A Break for Businesses Only?”

 That House Speaker John Boehner would ask this question shows either:

a)    how little he understands about the Affordable Care Act; OR

b)    how committed he is to making sure that the American public  does not understand the purpose of health care reform.

I would pick “b”.

Republicans are now suggesting that if the employer mandate (requiring that businesses offer benefits to their workers or pay a penalty) is being postponed until 2015, the Obama administration should postpone the individual mandate as well.

“Is it fair for the president of the United States to give American businesses an exemption from his health care law’s mandates without giving the same exemption to the rest of America?” Boehner asks.

What he ignores, of course is that under the Affordable Care Act, .middle-income as well as low-income citizens would receive generous tax credits to help them purchase insurance. Not long ago, I wrote about those subsidies, and a new “subsidy calculator” that will let an individual estimate how large his subsidy would be).

More than 26 million Americans will be eligible for these tax credits next year–though most dont know it. And by attempting to delay the individual mandate, the GOP is trying to make sure that they don’t find out.

       The Individual Mandate and the Employer Mandate Are Not Connected

Meanwhile Boehner pretends that the two mandates are somehow connected, In fact, they have nothing to do with each other. 

 The individual mandate exists because, under Obamacare, insurers are required to cover people suffering from pre-existing conditions. Aetna will no longer be able to shun the sick, nor will it be able to slap them with sky-high premiums.

This part of the law is extremely popular. Most Americans understand that any one of us could be diagnosed with cancer tomorrow. The goal of the law is to protect all of us against the vicissitudes of fate by ensuring that we have access to affordable insurance.

But if there were no individual mandate requiring that we all purchase insurance (or pay a penalty), a great many people would wait until they became ill, and only then buy insurance.As a result the insurance pool would be filled with folks who need expensive care, and everyone’s premiums would spiral.

If we want to insist that insurers cover the sick, we also must insist that everyone join the insurance pool. We all share in the risk of becoming sick, and so all must share in the cost. Ultimately, insurance is all about “pooling the risk.”

(Those who believe that they shouldn’t have to join the pool because they are young or  because they don’t smoke, exercise regularly and generally “take care of themselves” are ignoring the most basic fact about the human condition:  “all flesh is grass”. )

The requirement that insurers must cover a 30-year-old suffering from MS cannot be separated from the individual mandate. We cannot have one without the other. The architects of health care reform understood the connection

By contrast, the employer mandate has little to do with the individual mandate. The phrases sound alike, that’s about it. The individual mandate and the employer mandate do not depend on each other.

If some employers decide that they will wait until 2015 before offering comprehensive, affordable health benefits, their employees will be eligible for subsidies to help them purchase their own coverage.  Postponing the employer mandate in no way affects their ability to obtain coverage at a cost they can afford. Alternatively, if an individual decides not to purchase insurance, next year, he will be asked to pay a penalty of just $95.

This is what Fox News calls “a hefty fine.”

 

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What if the Court rules that insurers don’t have to cover people suffering from pre-existing conditions?

The following post originally appeared on the healthinsurance.org blog.

In March, Ethan Fidler, a 10-year-old from England who had just had a tumor removed from his brain flew to Florida where doctors at the University of Florida used proton therapy to blast lingering cancer cells. (While proton therapy is widely available in Western Europe, the UK government has only recently approved funding the technology. Ethan couldn’t wait.)

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