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The Senate Health Bill: Federal Micromanagement of Health Insurance

Posted By Edmund Haislmaier On November 20, 2009 @ 12:12 pm In Obamacare | Comments Disabled

Senate Majority Leader Harry Reid’s (D-NV) giant new health care bill [1] contains the same provisions as the other House and Senate bills to establish Federal micromanagement of all private health insurance.

Like the others, the Reid bill would subject all private health insurance — whether purchased from an insurance company by employer groups or individuals, or provided through an employer or union self-insured plan — to detailed Federal regulation.

These so called “insurance reform” provisions amount to a de facto nationalization of health insurance and they would produce that effect regardless of whether or not Congress creates another, new government-run health insurance plan.

Benefit Control. Of particular concern to patients should be that the detailed benefits in their health insurance coverage will soon be determined by the Federal Department of Health and Human Services. Last week, Americans got a foretaste of what Federal health benefit regulation means when the U.S. Preventive Services Task Force changed its recommendation [2] for breast cancer screening (mammography) for women aged 40 to 50 from “B” (recommended) to “C” (not recommended).

Normally, such recommendations would not create controversy as, until now, they have been merely suggestions to guide providers and health plans in making their own decisions for their patients or members. But under the proposed legislation they would take on the force of law, since the legislation will require all plans — starting in 2011 in the Reid bill — to provide coverage (with no patient co-pays) for, “items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force.”

Thus, a decision by a, heretofore, obscure HHS Task Force to recommend a specific medical service would in the future carry the force of law, and would impose additional costs on insurers and employer health plans. Conversely, any decision by the Task Force to issue a “C” or “D” rating (not recommended) — as it did last week in the case of breast cancer screening — will be henceforth viewed by insurers and employers as a justification for discontinuing coverage.

Cost Impact. Over time the more specific HHS gets in its benefit requirements — driving up the cost of coverage — the greater the incentive will be for insurers and employers to control those escalating costs by not covering anything that they aren’t absolutely required to cover by federal law.

The eventual result will be that the only medical care paid for through private health insurance will be the specific, items and services required by federal regulations promulgated by HHS. At that point, Congress will have effectively nationalized the entire American health insurance system under the supervision of the Secretary of HHS — regardless of whether or not it also sets up yet another government health insurance program in the process.


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URL to article: http://blog.heritage.org/2009/11/20/the-senate-health-bill-federal-micromanagment-of-health-insurance/

URLs in this post:

[1] giant new health care bill: http://www.cbo.gov/ftpdocs/107xx/doc10731/Reid_letter_11_18_09.pdf

[2] changed its recommendation: http://www.foxnews.com/politics/2009/11/17/critics-health-care-rationing-new-breast-cancer-screening-recommendations/

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