On Monday, Rodney Davis proposed a new bill that aims to cover those with pre-existing conditions in the wake of the Affordable Care Act's repeal (a measure Davis supports).
You could be forgiven for praising Rep. Davis’s efforts. At first blush, it appears he’s making a concerted effort to preserve an aspect of the ACA that is overwhelmingly popular with the general public. Forcing insurance companies to cover those with pre-existing conditions has allowed hundreds of thousands of previously “uninsurable” Americans to get covered. This bill is undeniably a step in the right direction… right?
Turns out, not so much. Dig just beneath the surface of this bill, and you quickly see that this is little more than an empty gesture, intended to garner some political brownie points for an increasingly unpopular and unresponsive representative.
Unfortunately for Rep. Davis (and those of us in his district) there’s effectively zero chance this bill can accomplish what he wants it to. It all comes down to the individual mandate. An individual mandate essentially means you are required to have insurance. Requiring insurance companies to cover pre-existing conditions without also having an individual mandate (a major aspect of the Affordable Care Act) was a disaster when it was attempted by several states in the 90’s.
In a world where the ACA is gone (and the individual mandate along with it), Rep. Davis’s sickest constituents will see their premiums skyrocket due to healthy people opting out of buying insurance (currently they have to pay a penalty if they choose to opt out). This results in a significantly smaller pool of payees, most of whom are expensive to insure, which will drive costs through the roof for those that need insurance the most, as they’ll be the only ones buying it. Not only that, it will drive insurers out of state markets, as an environment in which only the sick are buying insurance is not a profitable environment for them to operate in.
Oddly enough, these are the very reasons Rep. Davis cites in his press release supporting the repeal of the Affordable Care Act. Confusing, right?
To recap: Rep. Davis supports repealing the Affordable Care Act. To bridge the gaps in coverage, Rep. Davis has proposed a bill that cannot work without the individual mandate he voted to eliminate. This unworkable bill will result in the same premium increases and fleeing insurers that he cited as his reasons for voting to repeal the ACA in the first place. At an estimated cost of 350 billion dollars just to repeal, I’m having a hard time figuring out how this helps anyone.
Rep. Davis also cites the “Better Way” plan being pushed by House Republicans as a replacement for the Affordable Care Act. Maybe there's something in there for the people left high and dry by Rep. Davis’s bill?
The solution put forth in the “Better Way” plan is to increase the use of “high-risk pools” for those with pre-existing conditions. What’s a high-risk pool? Put simply, high-risk pools allow those with pre-existing conditions (or who are otherwise uninsurable) to group together and buy insurance if they are unable to acquire it on the individual insurance market (as they would be if the ACA is repealed). Again, this is an undeniably good thing, right?
Unfortunately, but perhaps not unexpectedly, no. High-risk pools group the most expensive people to insure together, concentrating the risk as well as the costs. This effectively goes against the entire concept of buying insurance, in that you spread the risk around. This results in sky-high premiums for the insured, and exorbitant costs for the insurers. Much like Rep. Davis’s bill, we can be fairly certain that this won’t do enough to help those most vulnerable in the wake of the Affordable Care Act’s repeal because we’ve already seen them fail. Rep. Davis should know this, yet he doesn’t seem to. This really only leaves us with two options. Either:
- Rep. Davis doesn’t understand how his own bill, or health insurance in general works, or
- Rep. Davis knows these proposals won’t work and, promotes them anyways hoping he can reap the benefits of making an effort, without actually accomplishing anything.
Put simply, these proposals are dead on arrival. That’s unfortunate for Rep. Davis’ constituents, many of whom are wondering if they’ll be able to obtain insurance once the Affordable Care Act is repealed. This sort of symbolic but ineffectual effort is not just an example of everything that’s wrong with politics today, it’s a betrayal of the voters that put Rep. Davis in office. It’s no secret that Rep. Davis derives a majority of his support from the more rural areas of his district. These same areas will suffer the most as a result of the ACA repeal, and not only will they suffer from the initial repeal, their suffering will be prolonged by these expensive and ineffective “solutions”. Rep. Davis promised them he’d replace the Affordable Care Act with something better. Instead, they’ll be getting worse coverage at a higher price.
This isn’t just a betrayal of those that voted for him, it’s a betrayal of all those in his district that benefit from the Affordable Care Act (whether they know it or not) and expect him to act in their best interests. 1.2 Million Illinoisans stand to lose health coverage if the ACA is repealed, 671,000 of whom are working. At an even more granular level, 44,696 of Rep. Davis’s constituents will lose their health insurance if the ACA is repealed. The impact on the people Rep. Davis represents will be significant, and they deserve more than hollow legislation designed more to elicit pats on the back than to actually help the people that live in work in his district.
Personally, I believe Rep. Davis knows this can’t work. I believe he’s counting on you, his constituents, to congratulate him for making an effort and then leave him alone. I believe he doesn’t think you’ll call him on it. Whether you voted for him or not, I think you should. I think you deserve to know why something as important as ensuring those with pre-existing conditions are able to acquire affordable health insurance is being used as a political prop. I believe you deserve to know how Rep. Davis thinks these proposals can work in a world without an individual mandate, or work at all.
I would hope Rep. Davis would have done his research before risking the lives and livelihoods of his constituents on false promises and faux fixes. Unfortunately, it doesn’t appear that’s the case.