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Monday, September 5, 2016

Intolerable Discrimination, Ageism and Obamacare's Prejudice Codified into Law

With the sensitivities the new liberalism embraces from bathrooms to illegal immigrants to team names, the disgraceful Obama prejudice based on age--ageism is a presidential legacy of hatred and contempt that has garnered little attention and that illustrates a country uncommitted to reducing discrimination.

Obamacare is one of the most hostile laws ever passed when it comes to the traditional category of protection from discrimination--age. In fact, it singles out individuals based on age for singularly unequal treatment.

Insurance companies have always used their "metrics," and actuarial studies to single groups out, not for unfounded reasons but because that information points to increased costs for certain groups--in that way they have avoided anti-discrimination laws. Charging higher rates to those with pre-existing conditions was no more prejudicial than charging more to older Americans for health insurance, after all, based on the "numbers" those people, and discrimination is always about "those" people, cost insurers more.

But Obamacare has changed all that through its creators' desire to gain political points and "fix" the problem of people being denied health insurance because of pre-existing conditions. This political manipulation was used as one of many half-truths the President used to "sell" his pet project, Obamacare, never revealing that the idea of covering those with pre-existing conditions rather than denying them insurance coverage was a deal made with insurance companies, outlined in the insurance industry lobby's 2008 publication by AHIP (the lobby), "Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate,” produced by AHIP, 2008. The deal: We won't deny coverage to those with pre-existing conditions IF you by force of law provide us with EVERYONE capable of paying as customers--the individual mandate.

And so the deal was struck, all income-earning citizens would have to purchase a health insurance consumer financial product and in exchange those with pre-existing conditions would not be denied health insurance. Glorious right? Except the law went further, after all it had gotten a whole bloc of voting fans--anyone who had or anticipated having pre-existing conditions. The law not only prohibited denying individuals health insurance based pre-existing conditions, but provides that those with pre-existing conditions CAN NOT be charged more in premiums and this is where Obamacare became a discriminatory law.

Recall, insurers always got away with charging specific groups more in premiums based on "metrics," on actuarial calculations that determined that those individuals MIGHT cost more to cover with health insurance. Those with pre-existing conditions were among the many groups of individuals and Obamacare REMOVED that cost calculation from insurers' rate-fixing making it ILLEGAL to use the odds that someone with a pre-existing condition would cost more and should therefore pay a higher premium. Not only could there be no denial of health insurance, but there could not be a higher premium charged for that health insurance. Good political news for the half-truth salesmen.

But Obamacare DOES specifically allow for charging more to two groups, those who use tobacco and those who are OLDER. As a matter of fact, age is one of only two categories of people who CAN be charged more, singled out from among all the other groups that actuarially cost health insurers more and who traditionally could be charged more. Those with pre-existing conditions can't be charged more. Those who are obese can't be charged more. Those who are of child-bearing age can't be charged more. Those who use prescription drugs or any drugs, legally or illegally can't be charged more. Alcoholics cannot be charged more. ONLY those who use tobacco and those who are older.

So how did this get through? After all, though tobacco use is not a "protected" category and anti-discrimination laws don't protect people who use tobacco, AGE is. (Although, since Obamacare does protect drug users, alcoholics, the obese, it's arguable that perhaps tobacco users should not be singled out.)

The discrimination based on age in Obamacare should have attracted the attention of both young and old as well as the "new" liberals who pride themselves on tolerance.

Section 2701 entitled "FAIR HEALTH INSURANCE PREMIUMS," states (A) such rate shall vary with respect to the particular plan or coverage involved only by…age, except that such rate shall not vary by more than 3 to 1 for adults and…(iv) tobacco use."

The problem is NOT that insurance companies use age as a criteria for charging more, because historically they used any number of categories to charge more, the problem is that Obamacare ILLEGALIZED such selective charges for every group of individuals EXCEPT those who use tobacco and groups based on AGE. Putting tobacco use aside, it's not difficult to see that if you say that any number of statistically justifiable measures CANNOT be used to charge individuals more in premiums then singling out a group of people based on age for higher rates is discriminatory.

So why no outcry? A couple of reasons, first of all, because in the blame and shame era of Obamacare, few individuals pay attention to section 2701. The ignorance is pervasive.

First of all, many older people likely noticed the difference in 2701 that actually REDUCED the difference in how much more they could be charged than younger people from 5:1 to 3:1, three times as much versus five times as much, ignoring the fact that AGE under the law had become one of only two criteria insurers could use to charge more in premiums--discriminatorily ignoring all the other metrics-based and actuarially based circumstances that formerly justified higher premiums, including pre-existing conditions.

Second, young people really don't understand the law in my experience. They seem to feel that older people or those who smoke are the "reason" for their higher rates. Not so. Read section 2701. Eager to be part of the "new" liberalism bandwagon, I've heard very few younger people acknowledge that they are the tools of Obamacare and that the change in ratio permitting charging them more should make them the strongest advocates AGAINST ageism and Obamacare's age discrimination.

After all, if they can be charged one third of what older folks are being charged, 3:1, and older folks are arbitrarily singled out for higher premium charges than anyone else (drug users, alcoholics, obese, those with pre-existing conditions), then by law young people have been singled out for higher premiums too. Again, not the problem that a group is number-wise more likely to cost insurers more and therefore can be charged more, but a problem that the ONLY reason insurers can charge more is because of age (putting tobacco use aside).

Third, for the most part, young people are persuaded by "marketing," rather than reality when it comes to the salesman-in-chief's words. I mean, what person would like to be told that they are the tools, the key to making health insurance policy work (making it worthwhile for insurance companies) by forcing them to purchase the financial product of health insurance to "…create large pools of younger, healthier participants whose premiums would help offset the cost of providing care for older policy holders who use the health care system more"? http://www.cnn.com/2013/12/04/politics/obamacare-young-americans/.

Fourth, Obamacare disguises ageism against the young (versus older Americans) through expanded Medicaid options for low wage-earners, through the availability of catastrophic insurance for those under age 30 (the cheapest) in order to satisfy the law's requirements, through provisions that let young people off the hook by having their parents pay for their health insurance through age 26.

Still focused on blaming others for the healthcare crisis rather than understanding their "tool" status in Obamacare, many young people don't know that Obamacare is so determined to use them to even things out in the risk pool that there was little notice that this summer CMS enacted rules to remove an option that's been used by many of the young and healthy, short term health insurance plans.

In June CMS announced: "That it was curbing abuses of short term plans that exploit gaps in current rules to use medical underwriting to keep some of the healthiest consumers out of the Affordable Care Act's single risk pool." CMS went straight for the jugular: Some issuers are now offering short-term limited duration plans to consumers as their primary form of health coverage for periods that last nearly 12 months, allowing them to target only the healthiest consumers…such abuses of limited duration coverage increase costs for everyone else.

This isn't the first time Obamacare's tried to force young people into its "single" risk pool. After all, after the enrollment failure of last year, when consumers first started tasting the reality of increased costs (disguised by premium assistance and cost-sharing entitlement payments) last year's SILVER plans increased in price LESS THAN the cheaper bronze plans in order to discourage young and healthy individuals from choosing the cheaper plans.

Older Americans too seem oblivious to the discrimination, falling back on decades-long experience with insurance companies that use all sorts of criteria to charge more and failing to notice that Obamacare illegalized ALL THOSE OTHER CRITERIA except age and tobacco use in defiance of metrics and actuarial studies that indicate other enormous cost centers.

And even with the Obamacare legalization of discrimination based on age, the law hasn't worked to satisfy the insurance company demands as they seek to get those healthier people in and bemoan any claim they have to pay on behalf of the sick. Still they're raising rates, still they're dropping out of the exchanges, still our out of pocket expenses are going up because yes, insurers want a single risk pool--young healthy individuals and they will continue to punish everyone with increased rates and rules until they maximize their goal--force people to pay premiums and buy their product and pay out as little as possible.

Obama's age discrimination not only changed the hard-won protection against age discrimination that was the rule of law in our country for decades, but it sacrificed that protection without achieving success.