Reihan Salam pursues the issue:
Reader Jim Fair kindly pointed me to an important provision in the Massachusetts law that is not present in ACA, as I understand it. The following is from a summary provided by Healthinsuranceinfo.net:
- If you buy individual health insurance through Commonwealth Choice you may face a pre-existing exclusion period. No pre-existing condition exclusion period can be applied unless you have a break of 63 or more days of continuous coverage. Pre-existing condition exclusion periods can last up to 6 months. Commonwealth Choice plans can look back 6 months to see if you actually received care or treatment for a condition. In addition, pregnancy can be considered a pre-existing condition in individual health insurance. Genetic information cannot be considered a pre-existing condition.
- No preexisting condition exclusion period can be imposed if you are HIPAA eligible.
This strikes me as a powerful disincentive to going without coverage that effectively strengthens the mandate.
I wonder if Professor Cowen really wants a strong mandate, or is he just trying to explain to those who do the folly of the existing terms in terms they understand.
The Massachusetts provision quoted seems similar to rules we have in Washington State, although we don’t have the mandate. It has been surprising to me how there has not been much discussion duing the entire health care debate about how the different states regulate health insurance and what effects those differing rules have on rates, coverage, etc.
63 days is a federal standard per the 1996 HIPAA law. Also, I believe the exclusion of genetic sreening is also true at the federal level for the last few years (yes, George W Bush actually did some good things).
Brad, you’re right to say “… there has been no much discussion…” Remember that your government asked to discuss the reform after it has been approved –of course, now they don’t want a discussion of what it has been approved.
Nancy Pelosi said: “But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.” Source: http://www.speaker.gov/newsroom/pressreleases?id=1576
On post-approval rejection of discussion, Michael Moynihan has written: “And while we are on the topic of 9/11, how quickly we forget that in the editorial rooms and bar rooms of the Bush era, the vapid phrase on the lips of my liberal-minded comrades, repeated like a Maharishi mantra, was that “dissent is patriotic.” Now dissent has become the first indication of incipient fascism and subterranean racism. If Rich sees in the current debate the seeds of pogrom, if Krugman sees the rhetoric of “eliminationism,” forget national heath care—we need a national history lesson.” You should read Moynihan’s article: http://reason.com/archives/2010/04/01/were-all-racists-now
“andrew – i think you have it exactly backwards.”
I don’t think so. They may have intended to address people who don’t insure until they get sick (in other words they have a pre-existing condition, so somehow it’s okay to do things that insurance companies are not allowed to do) but they can deny you coverage for 6 months for a 63 day break in coverage.
So you lose insurance for 2 months and they can deny coverage for a condition for 6 months. Of course it is perfectly reasonable for the new insurer not to want to pay for the condition you developed while not insured or insured by someone else. As the insured person with a break in coverage that is not that long compared to unemployment periods these days, it is reasonable to think that some of your past insurance coverage should be able to go with you at least to bridge the gap. Here the government was supposedly going to fix this problem and they’ve written a lot of words and jargon, but it looks to me like all they y did here was make it worse.
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The page that Jim Fair pointed you to was last updated in September 2007; it does not apply to current law in MA. The current law provides no exclusion for evidence of insurability or pre-existing medical conditions.
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