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Republican health care plan throw federalism under the bus

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Connecticut citizens are about to find that their insurance premiums are rising because on Dec. 19th its Department of Insurance issued an edict . It read that the American Psychiatric Association listed gender dysphoria as a disease and because it is a disease, the department mandated that insurance policies issued in Connecticut would cover gender dysphoria operations.

Translation: Insurance companies must cover transgender operations. By some estimates, mandates drive up the costs of insurance for everyone else by 30 to 50 percent.

Republicans recognize the problem and their solution is to allow purchase of individual insurance across state lines. With this, a Connecticut citizen could lower their insurance costs by purchasing their insurance in a state with fewer mandates. This was one of the planks of the Republicans 2010 Pledge to America . H.R. 3121 is a 182-page Republican health care reform bill that has such a provision.

The problem is that this overrules state law and this flies in the face of federalism where the powers of the federal government are limited.

Republicans need a better idea than throwing federalism under the bus. They should start by understanding the problem of mandates for individual insurance stems from job-based group insurance. Companies are in business to make profits, and keeping the cost of labor down improves profits. They do this by skimping on the coverage they offer their workers.

For instance, some companies might not include obstetrical benefits. To combat this, states mandate that insurance cover obstetrics. Very few companies would include the benefit of transgender operations and very few employees would object to its not being included.

However, politics come into play. The GLAAD special interest group lobbies the Connecticut Dept. of Insurance to coverage transgender operations and the department complies. This drives up the cost of individual health insurance as well as job-based insurance.

What is the Solution?

  • First Republicans should have principles, and two of them are a respect for federalism and free markets. They should refrain from proposing national solutions to the problems our national government caused. They should consider that a free market in medical care consists of most care being paid out of pocket and by individually owned health insurance.
  • States should separate the mandates for individual and employer owned health insurance policies.
  • The federal government should end the crony capitalism of subsidizing job-based health insurance with the tax codes.

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