Let’s Hope the Premium Caps Stay in Place

The idea of government mandated health insurance makes me uneasy.

I’m willing to be taxed to support public health insurance (like public schools) or insurance assistance (like food stamps). But I don’t want to be forced to buy a service.

Hillary Clinton is the only candidate still really in the race whose plan includes a universal mandate. But it does have one saving grace, which I don’t think was in the first publicly available draft: premium caps (at least relative caps proportional to income).

Phew! Otherwise, it would really feel like we were being made to subsidize a cartel.

But one bit of caution: I know a thing or two about legislation… “minor” details are easy to change. A few years ago, I worked with a piece of legislation authorizing a New York State public authority to extend the life of its debt. When it was first enacted, this entity was to expire within a certain period (I will spare you the complicated conditions for determining the date). But all of that notwithstanding, there was a final date, a drop-deadline (“date certain” as politicians like to say) by which the entity absolutely had to pay off its debt and dissolve itself.

The language was “in any case no later than the earlier of” the drop deadline date OR the period determined by complicated calculations.

The legislature quietly changed the word “earlier” to “later.” Keep in mind, thirty years earlier, when the statute was first enacted, there was more than a little controversy about whether it was a worthwhile project AND about whether it was sufficiently sunset-ed (new verb alert). But the “revision” caused little public outcry. Very few even heard about it. As I recall, the new formulation ultimately didn’t work out because of unrelated political reasons (but the debt still got refinanced a different way).

When the dust finally settles on the health care debate, if we go the mandate route, let’s remember to watch carefully so that insurance companies’ quasi-mandate to keep rates down don’t quietly disappear from the books one fine session in Congress.

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