Rep. Steve Scalise, R-La., is supposedly ready to unveil House conservatives’ long-awaited replacement for the Affordable Care Act. Based on this description, I’m very curious to see what they come up with:
“We address that to make sure that people with pre-existing conditions cannot be discriminated against,” he said.
He promised, however, that it would not “put in place mandates that increase the costs of health care and push people out of the insurance that they like.”
So here’s one example of the kind of costly mandate that a free marketeer might want to avoid—a mandate that insurance companies not discriminate against customers with pre-existing conditions. Insuring a sick person, after all, is a lot more expensive than insuring a healthy person. So normally you want to charge sick people more. Discriminate against them, as it were. But if that’s not allowed, then you’ll have to raise prices across the board. And yet those higher prices are going to push people out of the insurance they like, leaving you with an even sicker group of people in your pool. That’s the famous insurance “death spiral” that the Affordable Care Act is supposed to break with the injection of subsidies and penalties.
My strong suspicion is that Rep. Scalise is not in fact some kind of public policy prodigy who’s thought his way out of a dilemma that’s gone unsolved by the governments of all 50 U.S. states and every industrialized country on the planet. But maybe I’m wrong and we’re all about to learn that 100 percent of the thorny political difficulties of Obamacare can just be waved away. That’d be nice.