June 5 2012

ObamaCare: Bad for Women (and Men)

Tampa Tribune

Hadley Heath

Democrats can praise practically every big-government program for its "benefits" to women. More women than men struggle financially, so any government subsidy or anti-poverty program can be said to "especially" help women. This was a tactic employed to advance Obamacare and now is being used to scare the public about a possible Supreme Court decision striking down Obamacare as unconstitutional.

Americans should reject this identity-politics game and focus on the bigger picture: We are all health-care consumers, and we all generally want the same things: high quality; lower, more transparent costs; better access; and greater choice. Sadly, Obamacare will not give us any of those things. That leaves liberals trying to divide the American public into demographic sets and subsets, highlighting small, targeted benefits (but never mentioning the costs they create).

That's exactly what the Center for American Progress (CAP) did in its recently released study and video lamenting the three ways that ending Obamacare "will hurt women." Those three ways are loss of no-cost preventative services such as mammograms and contraception absent Obamacare's mandates, the end of a rule preventing insurance companies from taking gender into account when determining premium prices, and the reversal of Medicaid's expansion.

Yet Americans should recognize that in selling this idea of Obamacare as beneficial to women, CAP looks only at one side of the ledger — at the benefits that women receive — without looking at the costs and unintended consequences of those benefits.

First, Americans should be warned that "no-cost" services are actually extremely costly. The costs of each new "free" benefit that insurance companies are required to provide — whether that's contraception or mammogram services or access to chiropractors or fertility treatments — end up being built into insurance premiums.

Second, while Obamacare's ban on gender-based price "discrimination" in health insurance is touted as the end of a sexist practice in health insurance, it is really just shifting real costs from one group to another. Gender-based price discrimination isn't sexist; it reflects an actuarial reality that women are more expensive health consumers.

It's the same thing in reverse for auto insurance. Women (jokes aside) are safer drivers than men and file less expensive auto claims. This means that women, in general, pay lower auto insurance premiums. Women shouldn't have to subsidize the risky driving behaviors of men, and men shouldn't have to subsidize the health-care decisions of women. This is a question of fairness.

And when the government intervenes so that insurance premiums no longer reflect someone's actual expected health-care costs, this creates market inefficiency that requires more government action to correct. This is why Obamacare ended up with the constitutionally dubious individual mandate. Regulations that limit insurance companies' ability to account for age, gender or health status to determine premiums make premiums so expensive that a healthy, young man may be better off without insurance. That's why the government instead wants to force him into the market, so he will end up paying health-care costs that aren't his own.

Third, in another big-government effort to help (especially poor) women, Obamacare contains a sweeping expansion of Medicaid. Far from a benefit, this will condemn millions of women to the plight of Medicaid patients today: long wait times, poor care and difficulty finding doctors.

If we want to make health insurance more affordable, we should go a different direction entirely with Medicaid (much like a pilot program in Florida that gives Medicaid beneficiaries a choice among private plans), so that the individuals in society who are most in need can have a real safety net, not a false promise. Remember, health insurance doesn't equal health care, and a Medicaid card in your wallet is pretty worthless unless you can use it to access real, quality health care.

The "benefits" for women in Obamacare are not what they seem. They all come with indirect consequences that will be harmful, not just to women but to everyone. So next time you see an article touting the benefits of a certain law or program to one specific group of people, look for what's missing about the costs of those benefits and their overall effects. In Obamacare's case, we'll be hoping that these government "gifts" to women come packaged with a receipt.

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