Now that the election is over, those who voted for change because they wanted health reform repealed had better prepare for disappointment. Here are six reasons why it’s not going to happen, no matter what campaigning politicians may have said.
First, no politician is going to vote to reopen the Medicare donut hole again. The one millionth $250 rebate check was mailed out in August, and the 2 million plus who will eventually get them are not about to give them back.
The donut hole will start closing in earnest in 2011, and the scores of people in every Congressional district who will benefit from lower out-of-pocket drug costs will remind members of Congress that they’re paying attention and they vote. No newly elected member of Congress is going to risk offending these voters right from the start.
Second, people don’t want insurance companies to be able to deny them coverage all over again for their pre-existing conditions when it took so long to win this battle legislatively.
A huge percentage of Americans now has at least one chronic condition. The one in three who has hypertension, the one in ten who has diabetes, the one in ten who has cardiovascular disease, the one in seventeen who has a serious mental illness, and the one in thirty who has cancer simply don’t trust their insurance companies to insure them without a government mandate. It matters to them that reform gave them the right to coverage, and they will not be happy if their newly-elected representatives take it away again.
Third, people don’t want insurance companies to be able to cancel their coverage when they get sick or reach annual or lifetime caps. They hate it when insurance companies cancel their homeowners insurance after they file a couple of claims. How do you think they feel when it’s their health and well-being at stake? Does anyone really think politicians will wear pink and then vote against breast cancer patients?
Fourth, parents want their kids to be able to stay on their policies while they’re in their early and mid-20s.
Young people just starting out in entry level jobs with limited benefits can’t afford to buy health insurance on their own, and small employers also often can’t afford to provide it. Allowing young adults to stay on parents’ policies benefits both young people and small businesses. Politicians may be willing to risk a vote against one of these constituencies, but not both.
Fifth, early retirees worry a lot about health insurance, and absent the opportunity to buy into Medicare love the provision that allows them to stay on their employers’ plans after they take their retirement. The average retirement age in the United States is now 62, and many Americans have five to ten years between retirement and the start of their Medicare benefits.
Think these people don’t need their health insurance? Think again. Almost 3,000 employers applied to the government to offer reimbursed coverage to retirees as of the beginning of October, including large and small private employers, state and local governments, educational institutions, and nonprofits. Will members of Congress take on all these groups at once?
Sixth, people know premiums are already too high, and they’re not going to vote for someone who assures that they will go even higher. Remember, the savings associated with health reform were front-loaded.
Repealing popular provisions of health reform will load significant costs onto health care in the short term, while reaping few benefits. Think it was tough running for re-election after voting for health reform in 2010? Imagine running for re-election in 2012 after taking away its benefits as health care costs and premiums rise out of control again for two more years.
People’s desire for decent, affordable health care didn’t disappear with this year’s elections. In fact, it’s just the opposite. If anything, they still think health care costs too much, and they expect more from their government, not less. Public officials who don’t care won’t last long in public office.
So what might happen, as public officials scramble to figure out what to do next while under pressure from the right and the left to fix reform? I would guess that the so-called “individual mandate,” which assesses a higher income tax starting in 2014 on people who don’t buy insurance, will stand in as a surrogate for health reform, and some members of Congress will make a serious effort to target that one provision for repeal.
Since this will affect no one between now and the 2012 election, it will be a safe debate for the new Congress to have, and give the appearance of doing something while accomplishing nothing and offending no one. Winning or losing won’t really matter, so it’ll be a perfect issue for an otherwise deadlocked Congress.
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