An Idea for Making the Affordable Care Act Better

Unlike the Affordable Care Act supporters I am trying to think of ideas on how to make the law more efficient and less partisan. My guiding principle is that we should pursue the simplest health care reform policies until we find a more complex form that actually provides some measurable benefit. This is a variation of Occam’s Razor or the KISS principle. Part of the problem with the Affordable Care Act supporters is that they have consciously pursued complex polices when a simpler policy would be more than adequate. As an example Josh Barro at Business Insider argues “If You Like Your Health Plan, You Probably Shouldn’t Be Able To Keep It”.

But here’s the thing: One of the key reasons that America needed health care reform is that a lot of existing health plans were bad. There are a lot of health plans that Americans shouldn’t be able to keep.

Some old plans were bad because they had big holes in coverage, like plans with annual and lifetime benefit limits that could leave beneficiaries destitute if they got hit with major illnesses. Other plans were bad because they covered too much, encouraging beneficiaries to consume needless care because they had little or no financial responsibility at the margin.

In effect he is arguing that we should throw the baby out with the bath water because there are holes in the coverage in the low cost plans and too much coverage in the high cost plans. I have a lot of problems with this argument. I looked at my current, grandfathered plan and it does not have any holes that I consider significant. I have a passion for the details so I ran it through the actuarial spreadsheet and it comes in at 64.1%. Considering that it has both a lower price, $391, and a lower deductible, $3000/$5000, than the Affordable Care Act plans, it looks like the better deal. Probably the biggest problem I have with his argument is that I am beginning to believe that the price for the plans is a top down decision that does not reflect the actuarial costs from closing holes in existing plans. The pricing appears to be based on what the government/insurance companies feel the market will bear without political consequences. There is a collusion/corruption smell coming from the Affordable Care Act and it shows up as higher prices. So we have replaced a somewhat efficient, honest individual insurance market with a less efficient, dishonest market. The price increases are a pretty good indicator that we are going in the wrong direction!

For me and most healthy people the Affordable Care Act plans are the 4th best health care reform option. So here is a simple solution that is not politically charged. Let the grandfathered plans coexist for a couple years more with the Affordable Care Act plans. When the Affordable Care Act supporters start embracing the value option for healthy people, these plans will quietly go away.