Community Rating for Health Insurance: the Way to Get to Better Health, Better Care, and Ultimately Lower Cost for Our Citizens

The Affordable Care Act and health insurance explained… (No broccoli madness here).

But what about people under age 65, who find themselves with a disease? Before the Affordable Care Act (derogatorily called “Obamacare” by people who don’t like the act), if you had a “pre-existing condition”, in other words, you had a chronic disease before you applied for insurance, the insurance company could refuse to cover you or to use “experience rating”. In experience rating, you could be charged a very high premium because you were already sick. Is this fair? What if you had just lost your job and while you were looking for a new one, you learned that you had breast cancer? What if you were a small business owner with 25 employees and your premiums were experience rated and two of your employees developed cancer? Most Americans believe that this is not fair.

The Affordable Care Act eliminates this unfairness. It says that insurance companies can’t discriminate in setting higher rates because someone already has a disease. But, in order for this to work, the insurance company needs the healthy people to pay the same rate as the sick people, just like fire insurance companies need the payments of the people whose homes won’t burn down in a given year to pay to rebuild the ones that will. There must be an individual mandate for all Americans to have health insurance just like there is a mandate for us all to pay so that Medicare will cover us when we reach 65. I was a citizen of Massachusetts when Governor Romney introduced their law and I was proud of him for doing that. In Massachusetts now, almost everyone has health insurance and they don’t have to worry about not being able to get care or go bankrupt when they are sick. Hopefully, the Supreme Court will understand this logic, so average Americans in the other 49 states won’t have to worry.

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