Indivisible–Tu–CMR, Pre-Existing Conditions, and Fuzzy Economic Thinking

Dear Group,

When McMorris Rodgers says, “I believe we must protect people with pre-existing conditions and ensure their health care needs are met,” (Spokesman, September 30) she is sincere, but she is also shining light on a fundamental misunderstanding of insurance and economics.

Of course she is sincere. She is a concerned mother of a child with Down Syndrome, a clear example of a pre-existing condition. Health insurance for a person with Down Syndrome in the pre-Affordable Care Act days (pre-2009) was either astronomically expensive or simply not available, not offered. Why would an insurance company sell insurance to cover an individual with known Down Syndrome, a condition with many known complications that are expensive to treat? Being forced to cover a lot of patients with pre-existing conditions like Down Syndrome is economic suicide for a health insurance company. It is in the best interests of every health insurance company to steer such patients elsewhere, or charge them premiums consist with the cost of providing their care.

McMorris Rodgers understands preexisting conditions on a very personal level. She really does want other people with pre-existing conditions to be able to avoid paying directly for treatment they need. That’s just right, isn’t it? After all, Down Syndrome really isn’t a result of poor choices in life so it is rightand justthat insurance companies should take on the economic risk of the disease.

But wait a minute. Isn’t this the same Congresswoman who voted to repeal the Affordable Care Act some fifty times over the last eight years, voted to repeal without considering the mandate to cover pre-existing conditions would vanish with it? Where was her personal sincerity over the plight of her son with Down Syndrome while she was mouthing the Republican talking points about restoring the “free” market, about “choice,” and how the government mandating the purchase of health insurance was “unconstitutional?”

Now, she and Republicans are busy backfilling. “No, no, actually, we want to protect people with pre-existing conditions! Forget what we voted for! We really didn’t mean it. We really are compassionate and caring. Quick, quick, we just put some bills in the hopper in the House that prove our sincerity!” I encourage you to read this article from the October 11 Washington Postfor full review of the Republican backfill efforts on pre-existing conditions. Or read Shawn Vestal’s scathing critique (May 3, 2017 Spokesman) of McMorris Rodgers’ lack of commitment to the pre-existing conditions clause in the lead up to the Republican AHCA, their failed, high profile, “repeal and ‘replace’” attempt.

But here’s the deeper background: McMorris Rodgers must have missed Economics 101. Her fuzzy economic thinking is on display.

1) Any person with a whiff of a pre-existing condition will cost more to take care of on average than a person with a clean health record. Insurance companies know this. They will do anything they can get away with to charge higher premiums to such people or turn them away. Insurance companies stuck with more patients with pre-existing conditions are automatically at a competitive disadvantage in the marketplace. They will raise premiums for everyone…or they will go bankrupt. That is basic “free market” economics.

2) In the same Spokesman article McMorris Rodgers says four times her goal is “affordable” health insurance (or health care). How does driving up insurance prices (as in #1) make insurance more affordable? Hmmm.

Points 1 and 2 are economically incompatible, but there is one more:

3) McMorris Rodgers expressed breathless excitement of Republican “momentum”when they repealed the Individual Mandate as part of the Tax Cuts and Jobs Act. The Individual Mandate, the requirement under the Affordable Care Act that everyone acquire health insurance or pay a fine, well, that was “unconstitutional,” and an infringement on citizens’ rights. I’m sure her excitement was real. After all, Republicans imagine themselves as the champions of such things. But wait. The economics of health insurance guarantee that if healthy people at little risk of illness do not buy health insurance then insurance prices will go up because the remaining folks are, on average, sicker and more expensive to care for.

#3 contradicts the goal of affordability, just like #1 does. This is basic economics of insurance. McMorris Rodgers gets a failing grade. Her thinking is fuzzy. As mother to a child with Down Syndrome she gets honorable mention for sincerity. She is not acting. She is real. She really doesn’t understand what she is doing…

If you listen a little longer to McMorris Rodgers, or any other current day excuse for a rational Republican, you will hear them trail off mumbling about “continuous coverage requirements,” “high risk pools” and “Pharmacy Benefit Managers.” These are paltry attempts to deal with problems of fundamental economics McMorris Rodgers doesn’t have the bandwidth to grasp.

Vote for Lisa Brown. She has a grasp of reality well beyond the economic basics at which McMorris Rodgers fails.

Keep to the High Ground,