April 19, 2010

IF THEY^ HAVE TO COVER YOUR PRE-EXISTING CONDITION...:

Gaming The Health Insurance Mandate (MERRILL MATTHEWS, 4/19/10, IBD)

hat if millions of Americans decide it's a better deal to pay the fine and remain uninsured until they need coverage?

It appears that's exactly what's happening in Massachusetts, which passed its own ObamaCare-like reform with an individual mandate in 2006.

Last year, Charles Baker, former CEO of Harvard Pilgrim Health Care, one of Massachusetts's largest health plans, noticed some health insurance brokers posting comments on his widely read blog. They were suspicious that people were applying for health coverage after a medical condition developed, got the care they needed, and then dropped the coverage.

Coverage for an individual, noted Mr. Baker, now a Republican candidate for governor, might be $2,000 to $3,000 a year, while the penalty was only about $900. So he asked his finance people to see if they noticed any discernible patterns. Boy, did they.

From April 2008 to March 2009, 40% of the individuals who applied to Harvard Pilgrim stayed covered for less than five months. Yet claims were averaging about $2,400 a month, about six times what one would expect.

Blue Cross and Blue Shield of Massachusetts has now confirmed it is experiencing similar problems.


...how does it make any sense to get "insurance" until you have a condition?

Posted by Orrin Judd at April 19, 2010 6:34 PM
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