There’s a hubbub today about a slight delay in a rather obscure Obamacare provision, and the GOP response has raised my hackles. So, I vent.

Thanks to Obamacare, all insurance plans will feature maximum out-of-pocket costs (MOOP) of $6350 annually. That means that the most you will spend on health care in any year is $6350–even if you have cancer, or a car accident, or give birth. They’ll also be indexed to your income; lower-income earners will have lower MOOPs. Prior to this, MOOPs were much higher, if you had one at all.

The fact that many plans didn’t have MOOPs is the cause of the most recent delay: employer-based plans that don’t currently have MOOPs will have an extra year to add the feature.

This isn’t good by any means, and I feel like employers and insurers had 4 years to track out-of-pocket costs for enrollees. But, as Ezra Klein points out, this is going to affect very few people for one year.

So what does Speaker Boehner say?

Once again the president is giving a break to big businesses struggling with his health care law while individuals and families unfairly remain stuck under its mandates.

A $6350 limit on health costs is a consumer protection, and a pretty awesome one at that. Today’s news is that a few people won’t enjoy this totally awesome consumer protection until 2015. It’s only a “mandate” if you’re an insurance company.

The “birth control mandate” is the same way. If you’re a person, it’s the birth control guarantee. You are guaranteed that your insurance will cover all forms of birth control for free. No more being surprised that you’re paying full price for Mirena, even though Paragard was covered.

It’s only a mandate if you’re an insurance company1. If you don’t take birth control, it means absolutely nothing at all.

What’s really striking about Boehner’s seeming opposition to MOOPs is that there’s another limit on damages that’s in the news this week: Ohio’s 2004 “tort reform” limitation on civil suits has limited the damages that a serial rapist must pay. And yet “tort reform” remains the only health policy that the Republican Party seems to support.

And “tort reform” is only a good thing if you run a company that regularly rips people off. If you’re a consumer, it just means that companies are incentivized to commit widespread fraud; after all, if the fraud makes them more than $500,000 they have a fiduciary duty to commit it.

“Job-killing regulations”? Those used to be called “consumer protections”, and companies usually hire people to make sure they’re in compliance.

The only argument that consumers get any value from these is that fraud and externalized costs have a deflationary effect on consumer goods.

To which I say: baloney! Is there the remotest evidence that this is the case? Yet the press treats these statements as gospel, rather than as a con game (for Mitch McConnell) or as the ravings of a megalomaniacal ignoramus (for Rand Paul).

There’s no real takeaway here. Just that we’re all consumers, and we all benefit from consumer protection laws. That one of our political parties is dead-set against any policy that benefits all Americans is pretty bizarre and depressing.

—–

1 Interestingly, Catholic Health Partners is offering insurance on the exchange. They’ll be Ohio’s only Accountable Care Organization (ACO), meaning that their insurance will largely only cover treatment at CHP facilities.

ACOs are a good idea and should work as discrete single-payer microsystems (though CHP’s insurance doesn’t seem particularly inexpensive). However, now a Diocesan entity will be subject to “the birth control mandate”, because they’ve decided to go into the insurance business.

Additionally, there are a ton of arcane and byzantine rules around what treatment you can and can’t get (literally, a lot of these rules were created by the Byzantine Empire) at a Catholic hospital, and this insurance will mean that you likely can’t get coverage for those treatments. Insofar as a number of them are part of the Women’s Health Amendment, that will be interesting.

 
  • Isn’t the MOST you can spend your maximum out of pocket plus your premiums? In my case, the most I can spend is 6,000.00 out of pocket plus 2,700.00 in premiums for a total of 8,700.00. A healthy chunk of a 30,000.00 income.

  • Luke Brockmeier

    Premiums are not included in the MOOP, so I misspoke. However, the $6350 MOOP applies to Bronze and catastrophic plans as well–which have lower/no premiums.

    Additionally, 1 Silver plan from each insurer will have a subsidized MOOP. I think, at your income, your MOOP in that plan would be $4000.

  • Red Rover

    “Discrete single-payer microsystem”? There’s no way that’s not a contradiction in terms. The whole point of a single-payer system is to maximize the size of the group and not have any competitors, usually along political boundaries like countries or states.

  • Red Rover

    Also: “after all, if the fraud makes them more than $500,000 they have a fiduciary duty to commit it.”

    Yay, capitalism!

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