The site Generation Opportunity is great because it attempts to educate people age 18 to 34 on tough issues that often don’t garner much attention, like Obamacare. But young people in the context of Obamacare must-haves should pay attention to issues that are larger than age to avoid advocating policy in the wrong way, which for purposes here means against their own self-interest. As this article indicates, I’m proposing Obamacare must-haves when it comes to ongoing changes with the law. Here I propose modification of the “free stuff” the preventive care provisions of the Act.
In order to embrace those 18-34, the GENERATION OPPORTUNITY readers, a little clarity might be helpful in their consideration of a summertime article written by Aaron Houlihan, advocating insurance purchases across state lines, https://generationopportunity.org/articles/2015/07/21/why-cant-you-buy-health-insurance-in-another-state/, because when it comes to must-haves, Mr. Houlihan I believe misses what’s at stake and what changes would benefit young people.
I cite Mr. Houlihan's article here because of two positive things: Young people learning about Obamacare and young people considering how it can be changed to benefit them.
Mr. Houlihan does not like that “Many state governments, at the request of lobbyists, require all health insurance plans to cover certain treatments, such as acupuncture or weight-loss surgery. These mandates can increase the price of health insurance by 30 to 50 percent.” Yet his argument OMITS the restrictions of Obamacare legislation that expanded mandated coverage including “free” preventive care.
I do like that he as a representative of the younger generation recognizes there’s no such thing as “free” under health insurance and that mandating coverage will result in increased costs to consumers. That means that paying attention to the “free” stuff is important. What misses the point are Mr. Houlihan’s consideration of acupuncture and weight-loss surgery as examples of what he’d like to see omitted from requirements ignoring the expensive elephant in the room under Obamacare: FREE PREVENTIVE SERVICES.
Under SECTION 2713 of the PPACA, Obamacare itemizes none of the overreaching expensive “free” stuff that ended up comprising the list put forth on healthcare.gov. That list is subject to change and originated with the recommendations of the US Preventive Services Task Force.
Having recognized the problem, on behalf of younger people, Mr. Houlihan should consider that in general free “checkups” benefit younger people who are often healthier than older people and therefore their out-of-pocket expenses for any given year can be minimized by making checkups free.
This free stuff, while not acupuncture or weight loss surgery, neither of which are mandated by Obamacare but in the case of bariatric surgery for 23 states have become part of the essential health benefits list,is hardly the place to start when it comes to the expense of requiring all health plans cover stuff. For that we start with Obamacare itself.
Sure, people like “free” stuff, but we know it’s not free. Sure young people should support free checkups but nothing’s free and “free” or not, supporting gender-biased and illogical provisions is not in the interest of young people or anyone else. With this in mind, while some preventive care can be considered a must-have in the face of potential Obamacare changes, some others should go.
Sexist provisions that require men to pay for services they themselves cannot get for free should be removed such as those allowing for free sterilization for women, but requiring men to pay copay, coinsurance and deductible for their sterilization. At most such sterilization for women should not be a free “preventive” service but perhaps an essential health benefit which is susceptible to copay, coinsurance and deductible provisions but must be covered by all plans.
Free domestic violence counseling for women only should also be stricken from the “free” stuff list. There is a significant percentage of the male population also victimized by domestic violence and though while more frequently a “female” problem, males should not be obliged to pay for a woman to get something for free that they cannot.
Free annual checkups for women are included but not for men. Again, men should not be required to pay for this coverage for women that they can’t get. (Go to healthcare.gov and look at free preventive for all adults, no annual wellness for men).
Then there are the provisions where insurance companies essentially get to charge twice—the child provisions that are included in the “free” stuff we all pay for but that are not available to any child unless a separate insurance policy is purchased covering that child which ALSO included payment for child “free” stuff. This is a double-dip and should not continue.
So, some preventive health care that’s “free” for checkups benefits young people who frequently are healthier and therefore won’t accrue expenses beyond the “free” checkup. However, overkill that includes gender-biased provisions and provisions designed to benefit children that cannot be beneficial to any child who is not enrolled separately in a health insurance plan are not money well spent for young people or anyone else.
For individuals whose free checkup actually requires medical care or services, "free" preventive care can become a barrier to health services because first, we know that insurers who now have to provide the "free" checkups have increased what we pay for needed medical care in the form of deductibles, copays and coinsurance, and secondly because the list of free stuff is not all-encompassing, we may be pushed into the checkups that are covered by health insurance under Obamacare which providers know they’ll get paid for while omitting free checkups, and therefore checking for things like prostate cancer and melanoma.
Therefore, SOME preventive care “free” stuff should be a must-have under Obamacare in addition to the Out-of-pocket maximum and the prohibition against denying health insurance based on preexisting conditions. But, as with our other must-haves, modification of the provisions is not only preferable but necessary to maximize the protection afforded all consumers.
