The Affordable Care Act banned some of the private insurance industry’s worst practices, like denying coverage based on preexisting conditions, but that doesn’t mean they were just going to stop trying to find ways to get out of paying for customers’ health care. It simply started a game of consumer protection whac-a-mole where the industry comes up with innovative ways to screw sick people.

Over at The Upshot Charles Ornstein looks at how insurance companies are designing their drug plans to discourage people with serious illness from signing up or make them pay more. From NYT:

Insurers have long tried to steer their members away from more expensive brand name drugs, labeling them as “non-preferred” and charging higher co-payments. But according to an editorial published Wednesday in the American Journal of Managed Care, several prominent health plans have taken it a step further, applying that same concept even to generic drugs.

The Affordable Care Act bans insurance companies from discriminating against patients with health problems, but that hasn’t stopped them from seeking new and creative ways to shift costs to consumers. In the process, the plans effectively may be rendering a variety of ailments “non-preferred,” according to the editorial.

Theoretically, it might be possible to have a decent health care system using only private insurance companies with broad latitude if you have a system of extremely good regulators and highly responsive lawmakers who would diligently work to whack each new mole as soon as it emerged. A system of regulators so strong, incorruptible, and flawless that insurance companies wouldn’t even try to game the system, having concluded it was impossible. Of course that is not what America has, especially with Congress stuck in a state of gridlock and many Republican state officials who don’t like the law.

Instead, we have system that forces people to buy insurance from these very unpopular private companies, and is not going to be quick or easy to address their game playing.

Photo by Jorge Alvarado under Creative Commons license

Jon Walker

Jon Walker

Jonathan Walker grew up in New Jersey. He graduated from Wesleyan University in 2006. He is an expert on politics, health care and drug policy. He is also the author of After Legalization and Cobalt Slave, and a Futurist writer at