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March 24, 2010

Ooops, Found A Mistake In The Health Care Bill! First In What Will No Doubt Be A Long Series
Updated: You Know, This Whole Thing Might Not Work

Remember the Democrats crowing about how kids would no longer be subject to pre-existing conditions exclusions anymore? Yeah, about that.

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

However, if a child is accepted for coverage, or is already covered, the insurer cannot exclude payment for treating a particular illness, as sometimes happens now. For example, if a child has asthma, the insurance company cannot write a policy that excludes that condition from coverage. The new safeguard will be in place later this year.

Full protection for children would not come until 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation. That's the same year when insurance companies could no longer deny coverage to any person on account of health problems.

Obama's public statements have conveyed the impression that the new protections for kids were more sweeping and straightforward.

"This is a patient's bill of rights on steroids," the president said Friday at George Mason University in Virginia. "Starting this year, thousands of uninsured Americans with pre-existing conditions will be able to purchase health insurance, some for the very first time. Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions."

It's almost as if this piece of crap was thrown together in a slipshod way. It's only 1/6 of the economy and people's lives on the line, so no need to sweat the details.

But don't worry, the administration says this isn't actually a problem and that they'll be fixing this by issuing regulations.

Laws are hard. You have to get people to agree and you have to be able to write precisely. So much better to administer things by executive fiat. I mean, what could go wrong with that?

Added: Now it can be told! With the bill safely passed, WaPo columnist Ruth Marcus says, you know, I'm not really sure this scheme is going to work.


In fact, the occasion called for more humility than hyperbole, however unlikely that may have been given the setting. If I were a member of Congress, my floor speech before casting a yes vote would have boiled down to:

Gee, I hope this works.

One of the astonishing aspects of the health-care debate is how little is actually known about the implications of a change this far-reaching. Everyone has a theory, and a model to match, but even some of the most fundamental questions remain the subject of debate.

On the most basic of all -- does having health insurance lead to better health? -- the evidence is solid but not unanimous. The Institute of Medicine, reviewing the literature in 2009, found that "the body of evidence on the health consequences of health insurance is stronger than ever before. . . . Simply stated: Health insurance coverage matters."

But a study that same year by Richard Kronick, a former health-care adviser to President Bill Clinton, found "little evidence to suggest that extending insurance coverage to all adults would have a large effect on the number of deaths in the United States." Kronick's study has been criticized because it did not adjust for the fact that those in poor health are more likely to seek insurance. But the disagreement underscores the difficulty of knowing precisely what changes are in store.

Um, isn't that pretty much what Republicans have been saying for over a year now? Back in the day that used to get you called racist and someone who wanted poor people to die. Now it gets you a spot in the Washington Post.

Marcus concludes it's worth the risk. I guess that sporting of her and all but hope ain't a strategy. Unless you are running for President.

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posted by DrewM. at 11:35 AM

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