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The Ensign Healthcare Loophole

Yet another big, steaming pile of "change we can believe in."

Taken at face value, Senator John Ensign's amendment which was included in the final Senate healthcare bill sounds pretty decent: by meeting "wellness" standards people can receive discounts on their employer-based healthcare premiums. Stop smoking–pay less. Hit a certain weight–pay less. Meet a cholesterol target–you get the idea.

In fact, it allows premiums to be raised from current levels, and then "discounts" would reduce the premiums to current rates. People who don't meet the insurance companies' targets could pay up to 30 percent more for coverage, roughly $4000 based on the average cost of family coverage. The amount could increase to 50 percent which is over $6,600 for a family.

More below the fold.

There is also the problem that this is biased against people with a genetic predisposition to high blood sugar, hypertension, high cholesterol, being overweight and a host of other often hereditary conditions. It's also biased against a lower-income person working two to three jobs to pay the bills, who has to stop and chow down some fast food between jobs rather than get to the gym where he or she can't afford a membership anyway. It's even biased against communities that don't have grocery stores where they can find fresh fruits and vegetables.

So what does this all mean? Remember a central promise of healthcare reform — even the watered down version — how people with preexisting conditions weren't supposed to be denied coverage or forced to pay more for their insurance? That all sounded pretty good, right? Well, guess again.

“Incentives quickly become penalties for those who cannot meet the target,” said Sue Nelson, vice president for federal advocacy at the American Heart Association (AHA). The AHA has led a coalition of more than 200 health and consumer organizations who oppose this Senate provision, including the National Organization for Women, American Cancer Society, the American Diabetes Association, and many mental health groups. “A wellness program could consist solely of a premium surcharge based on a blood cholesterol count over 200. [There] are significant potential unintended consequences such as burdening sicker employees and their families with significant increases in healthcare costs thereby making coverage unaffordable for those who need it the most.”

The Nation: The Ensign Healthcare Loophole

At every turn, the Democrats snuggle up to the insurance industry in a nice warm bed while, outside in the cold and rain, Americans are dying for want of basic health care. Could someone please explain to me just how they are better than the Republicans?

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Gregory Gadow

Gregory Gadow