Experts debate how the health care mandate will affect individuals

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Karen Fritsche/KPCC

An audience members asks a question at the first public event held in the Crawford Family Forum.

One contentious aspect of the health care bill is the individual mandate to show proof of insurance. Beginning in 2014, most Americans will be required to purchase coverage or show proof of participation in a public plan, like Medicare or Medicaid. Some individuals will be eligible for a hardship exemption, while others will receive subsidies to make buying health insurance more affordable. Those who do not qualify or buy coverage will have to pay a fine.

Wednesday, AirTalk convened a panel of experts to debate the potential positive and negative repercussions of the health care mandate in the first public event for broadcast held in the Crawford Family Forum from KPCC’s new Mohn Broadcast Center.

Patrick Johnston, President and CEO of the California Association of Health Plans, an industry group that represents a number of the state’s major health insurers, said the individual mandate to purchase insurance will allow his members to provide affordable insurance to older Californians, and those with pre-existing conditions.

Lucien Wulsin, director of the Insure the Uninsured Project, said California over-relies on emergency medicine to serve the state’s many uninsured patients. He predicted that increased coverage would strengthen partnerships between clinic and county facilities in Los Angeles and ease the burden on emergency rooms.

Larry Mantle asked Wulsin who would not be covered after the policy’s implantation. He responded, “Principally, the undocumented.”

Jerry Flanagan, with Consumer Watchdog, expressed concern that the bill did not include sufficient cost containment measures which could lead to higher premium prices or policy rescission.

“I’m really fearful we’ll see a lot more denials of health care,” Flanagan said. “I can see the insurance companies wrapping themselves in a cloak — the Congressional bill, because it didn’t cap what they can charge for coverage almost gives them a carte blanche to go out and deny more and delay care more.”

Patrick Johnston of California Health Plans countered that there would be no more rescission of insurance policies.

“Medical underwriting is being eliminated. If you’re insured, there will be no lifetime cap on the amount of dollars spent on your medical condition.” Johnston added, “how clear can it be?”

Meanwhile, Cal State Northridge economics professor Glen Whitman remarked, despite the establishment of exchanges in the individual market, Congress is reluctant to change an employer-based model of providing health insurance.

Whitman agreed with Jerry Flanagan’s predication that additional regulation of premiums was imminent, but saw added market constraints as a burden rather than a protective measure.

“From the discussion so far what you can gather is there’s a kind of interventionist dynamic that’s happening, it’s a kind of domino effect,” Whitman said.

Asked whether the mandate was a necessary provision to pass health care, Wulsin told Larry Mantle, “The mandate is the glue that holds it all together.” He added, “There’s always a concern that if there’s not something that holds the group together, people will buy when they’re really in need of it and may not buy when they don’t need it.”

For the full Town Hall Mandate Debate, visit the AirTalk page.

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