You can’t have it both ways


In the days since President Obama signed a comprehensive healthcare reform bill into law, it has become de rigueur among GOP candidates for California’s higher offices to call for its repeal. More to the point, they’ve called on Atty. Gen. Jerry Brown -- a Democratic candidate for governor -- to join 14 other states’ attorneys general in suing to block the law. Republican gubernatorial candidate Meg Whitman even told a crowd of supporters Tuesday night that she would force the attorney general to file suit, though she admitted later that the governor has no authority to do so.

It’s no surprise that GOP primary candidates would oppose a law that’s wildly unpopular among the party faithful. Never mind that most Americans support its key provisions when they learn the details, including the creation of a new market for individual insurance policies and a requirement that insurers offer coverage to everyone who applies. The law’s opponents have convinced many Americans that it’s a government takeover of the healthcare system, offending even people who currently rely on government-supplied healthcare. This page wouldn’t support such a measure either, but that’s not what the law does.

A particularly disturbing aspect of the politicking has been the effort by some critics of the new law to have it both ways on the campaign trail -- to suggest that there’s a cheap and easy solution to the problems in the system that includes the most popular features of “Obamacare” but not the least popular ones. Whitman, for example, told reporters Tuesday that she would bar insurers from denying coverage to people with preexisting medical conditions but wouldn’t require the so-called individual mandate, under which Americans would be required to carry insurance. But that would be utterly unworkable. Such an approach would inevitably lead to even greater increases in insurance premiums because people would carry insurance only when they needed expensive treatments.


Other Republican candidates, including Senate hopefuls Carly Fiorina and Tom Campbell, would let insurers continue to dump people with preexisting conditions into state-run high-risk insurance pools. Campbell argues that this approach would avoid spreading the cost imposed by the sickest and most injured people onto the larger pool of people who carry insurance. But that’s the whole point of health insurance. Everyone is at risk of being injured or becoming ill, so it makes sense for those risks and costs to be spread broadly.

The current state high-risk pools charge far higher premiums and impose much greater out-of-pocket costs than the typical policy offered by private insurers, despite the subsidies poured in by taxpayers. That’s why so few people are in the pools today. The price gap would only widen under the approach favored by the likes of Fiorina and Campbell, while the cost to states would skyrocket. What these candidates are really arguing is that the adults most in need of health insurance should pay the most for it. That’s no way to expand coverage or improve the quality and efficiency of care. In other words, it’s not reform.