Democrats claim their newly passed health insurance reform, signed in March by President Obama, will eventually provide coverage for more than 30 million uninsured people. Don't bet on it.
The key to achieving that goal, Democrats argue—along with expanding Medicaid and subsidies for buying coverage—is the individual mandate, which requires individuals to have health insurance or pay a fine. The mandate is supposed to push nearly everyone into the pool, to minimize free-riding on the system.
But what 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 expressed suspicions 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, whereas the penalty was only about $900. He asked his finance people to see whether they could find any discernible patterns.
Boy, did they.
Between April 2008 and March 2009, 40 percent 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.
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