Health Care Policy Chaos

We were assured by Nancy Pelosi that we would have to pass health care reform in order to find out what was in it. We did, and most of the revelations about the details of the bill have been disquieting, to say the least. But at the very least, we’re no longer information-starved, right?

Alas, wrong:

Alabamians hoping to find health insurance through a new federally developed insurance marketplace won’t get any details before October, when the insurance options are scheduled to go online.

The U.S. Department of Health and Human Services reports it is working on completing the list of health insurance plans that will be made public Oct. 1, when people can begin signing up for coverage that will start Jan. 1. That gives the uninsured a three-month window to comply with the Affordable Care Act’s mandate for individuals to have health insurance by Jan. 1 or face penalties at tax time in April.

“It’s frustrating that we are not going to be able to get a preview,” said Jim Carnes, spokesman for Alabama Arise, a Montgomery-based organization that addresses issues affecting Alabama’s poor. Because of that, Carnes predicts a slow start to people signing up.

I am betting that Alabamians are not alone in wondering what is in store for them. Meanwhile, yet another news item telling us that the health insurance exchanges are not ready for prime time. And another unwelcome wrinkle in the law reminds us just how poorly constructed it is:

A “family glitch” in the 2010 health care law threatens to cost some families thousands of dollars in health insurance costs and leave up to 500,000 children without coverage, insurance and health care analysts say.

That’s unless Congress fixes the problem, which seems unlikely given the House’s latest move Friday to strip funding from the Affordable Care Act.

Congress defined “affordable” as 9.5% or less of an employee’s household income, mostly to make sure people did not leave their workplace plans for subsidized coverage through the exchanges. But the “error” was that it only applies to the employee — and not his or her family. So, if an employer offers a woman affordable insurance, but doesn’t provide it for her family, they cannot get subsidized help through the state health exchanges.

That can make a huge difference; the Kaiser Family Foundation said an average plan for an individual is about $5,600, but it goes up to $15,700 for families. Most employers help out with those costs, but not all.

“We saw this two-and-a-half years ago and thought, ‘Has anyone else noticed this?'” said Kosali Simon, a professor of public affairs at Indiana University who specializes in health economics. “Everyone said, ‘No, no. You must be wrong.’ But we weren’t, and that’s going to leave a lot of people out.”

The issue has recently received attention, especially after former president Bill Clinton highlighted it in a recent speech.

“The family glitch is definitely a drafting error that Congress made that needs to be fixed,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “But that seems unlikely.”

New rules state that those families will not be penalized for not purchasing coverage, but the point of the law was to make coverage affordable for families.

Jonathan Adler offers apt commentary: “It’s almost as if no one carefully read the bill that was passed. After all, this is hardly the only instance in which the text of the statute does something different than what the supporters had hoped.”