Garance Franke-Ruta, a good writer at the Atlantic, asks a bad question: why is maternity care such an issue for Obamacare opponents? In answering the question, the author documents some of the very same problems that I addressed a while back. Namely, my wife and I feel that we should not be forced to purchase certain healthcare benefits that we neither want nor need right now. Maternity care happens to be one of them.
To these objections, Franke-Ruta responds, “But uninsured women of childbearing age weren’t making choices between a Porsche and a Chevy in the pre-ACA world. They were trying to find a bus in sprawling towns where they had to walk while everyone else drove.” First of all, my opposition to Obamacare is far broader than the issue of women’s healthcare. If all the law did was to ensure that single mothers were able to obtain coverage for themselves and their infants, I would not have spilled any ink on it. The law mandates a number of other services my wife and I are willing to go without yet are forced to purchase, such as substance abuse coverage, pediatric services, and so on. And it is generally understood that more services means a more expensive product.
This fact seems lost to Franke-Ruta, who wonders why everyone cares about the maternity issue so much when the majority of employer-based insurance cover it anyway. The plan offered by my wife’s employer may have included more comprehensive benefits, but—no surprise—it was more expensive than our pre-ACA private plan. This is not merely anecdotal evidence. According to the Kaiser Family Foundation’s 2013 Employer Health Benefits Survey, the average cost of employer based insurance is around $4,500 per family per year. Prior to the ACA, my wife and I paid less than half of that figure. (Not to mention there are other alarming trends in the survey, such as the fact that the cost of health insurance is rapidly outpacing employee wages.)
And, in general, I prefer private plans because they offer a certain level of flexibility not found in employer plans. To obtain coverage through an employer, once must wait for the yearly enrollment period, which occurs once or twice a year. On the other hand, private plans allow one to enroll almost immediately, and the consumer is not tethered to the job for the sake of benefits. How many times have you heard someone say “Well I hate my job but I can’t quit because my children need health insurance”? Critics like to demonize private insurance because they say one can be dropped or have coverage denied for a host of reasons, but is that not the same with employer coverage? Hours can be reduced and coverage lost, or the employee can be fired. (Keep an eye out for a reduction in work hours when the employer mandate kicks in come 2014.)
Society as a whole stands to benefit from healthy people, especially women. Therefore I can understand the argument that my wife and I ought to think beyond just ourselves when it comes to insurance premiums. However, a number of tax dollars already go to support social programs for those women in need of assistance—as it stands, nearly half of all live births are covered by Medicaid. In addition, insurance isn’t exactly getting better under the ACA. If, as predicted by CBS in DC, premiums and deductibles increase due to a risk pool filled with the elderly and infirm, pregnant women may end up stuck with prohibitively expensive maternity care. Say what you will, but that is not effective healthcare reform.