Health Care "Freedom" Under The ACA
On November 8, the voters of Ohio overwhelmingly passed a “health care freedom” amendment to the Ohio constitution. Since there was very little publicity about this issue and no organized opposition to it, it passed easily throughout the state. But did the voters really understand what this issue meant?
This issue would exempt Ohio from participating in the individual mandate under the Affordable Care Act (ACA), sometimes referred to as “Obamacare.” However, since the act is a federal law, it trumps any action by an individual state. Thus it has no meaning and does not prevent the “individual mandate” from becoming effective on January 1, 2014.
However it could lead to what the issue’s proponents fear the most: the federal government running health insurance in Ohio. The amendment could prevent the state of Ohio from establishing their own insurance exchange as required under the ACA. The health insurance exchanges under the act are to be established and administered by each state and under the control of each state. But if a state does not have their exchanges up and ready on January 1, 2014, then the federal government will administer that state’s exchanges. The result of the passage of issue 3 could actually lead to the federal government taking over health insurance in Ohio.
This issue was couched in words like “freedom” from being forced to purchase health insurance. Of course if people do not purchase health insurance, then they are uninsured. Just who foots the bill when those who are uninsured actually need and receive medical care? Of course, it is those who are insured or the taxpayers. We subsidize the uninsured through higher costs for our own medical care or pay higher taxes to support public hospitals (like Parma Community or Metro) that deliver care to the uninsured.
Under the ACA, health insurance companies offering policies through the exchanges are forbidden to deny anyone because of pre-existing conditions, and insurance companies must cover all pre-existing conditions without any waiting periods. As any rookie in the insurance business learns, if many young, healthy people refuse to be covered because they do not want to pay for their health insurance, then more older and sicker people will be covered. That is called “adverse selection.” Adverse selection can have the effect of increasing the cost of insurance to the point where it becomes unaffordable.
Therefore to make sure that health insurance companies can cover all pre-existing conditions and not deny coverage to anyone because of their health, it is a requirement that everyone be required to participate. No one has the freedom to be irresponsible. If you want to drive a car, then you must purchase auto insurance. Failure to do so could result in the revocation of your driving privileges and a fine.
The issue of the constitutionality of the individual mandate in health care reform will be decided by the Supreme Court. Most court observers believe that the Supreme Court will uphold the individual mandate in the ACA. What the voters of one state do will have no effect on any Supreme Court decision, nor will it stop the implementation of the individual mandate on January 1, 2014. In the event that the Supreme Court rules against the individual mandate or what many also believe, requires a “public option” as a default so that if an individual refuses to purchase a health insurance policy on their own through the exchanges, they will automatically be enrolled in the “public option” and assessed a premium for that default choice.
Therefore those people who argue for "health care freedom" through this issue passed November 8 may unwittingly be asking the federal government to actually run health insurance in Ohio and perhaps impose the dreaded “Public Option”. Sometimes people should be careful what they wish for.
Lee Kamps
Lee has been working with Medicare, Medicaid and private health insurance since he began working at the Erie County Welfare Department in January 1973 where a major part of his job was determining eligibility for Medicaid. He went into the private insurance business in 1977 with Prudential Insurance Company and within a short time had become one of the company’s top sales agents. In 1982, he was promoted into management where he managed two field offices and as many as thirteen sales agents. After leaving Prudential in 1986, Lee decided to become more focused on health insurance and employee benefits. He has advised many local employers on how to have a more cost effective employee benefit program as well as conducted employee benefit meetings and enrollments for many area employers. The companies Lee has worked with ranged from small “mom and pop” businesses to local operations of large national companies. Lee received his B.S. degree from Kent State University where he has been active in the local alumni association. He has completed seven of the ten courses toward the Certified Employee Benefit Specialist designation. He has taught courses in employee benefits and insurance at Cleveland State University and local community colleges. In addition, Lee is an experienced and accomplished public speaker. He has been a member of Toastmasters International where he achieved the designation of “Able Toastmaster – Silver” in 1994. He has also served as a club president, Area Governor and District Public Relations Officer in Toastmasters as well as winning local speech contests. Lee has also been a member of the Greater Cleveland Growth Association’s Speaker’s Bureau where he was designated as one of the “official spokespeople for the Rock and Roll Hall of Fame” prior to the hall’s opening in 1995. He has given talks and presentations before many audiences including civic organizations, AARP chapters and many other community groups. With the implementation of the Medicare Modernization Act (Medicare drug bill) in 2006, Lee has shifted his focus to Medicare and helping Medicare beneficiaries navigate the often confusing array of choices and plans available. As an independent representative, Lee is not bound to any one specific company or plan, but he can offer a plan that suits an individual person’s needs and budget. In addition, Lee is well versed in the requirements and availability of various programs for assistance with Medicare part D as well as Medicaid. While he cannot make one eligible, he can assist in the process and steer one to where they may be able to receive assistance.