A “Trigger” for Destroying Americans’ Health Coverage

A “Trigger” for Destroying Americans’ Health Coverage

September 8, 2009

SEPTEMBER 8, 2009

Even as the Administration continues to search for a “compromise” regarding its government takeover of health care, an examination of one proposal being discussed exposes it as a way to enact an unpopular plan that would cause millions of Americans to lose their current coverage:


•  Press reports indicate that the White House and other parties are considering the inclusion of a “trigger” mechanism for a government-run health plan in legislation. Such a mechanism would trigger creation of a government-run health plan if 95 percent of individuals in a region could not purchase an “affordable” insurance product—defined as one costing fewer than 15 percent of family income.


•  However, Congressional Budget Office Director Doug Elmendorf has already testified that the Democrat legislation currently being considered would raise health care costs, not lower them. Moreover, the many additional mandates and regulations in the bill would force Americans to buy more costly insurance. Both trends would decrease, not increase, the “affordability” of health coverage—leading some to wonder how insurance companies could possibly comply with the “trigger” provisions, and whether or not the current system of privately-provided coverage is being set up to fail so that a government-run plan can take over.


•  While Republicans included a “trigger” for a fallback plan in the Medicare Modernization Act at the insistence of Senate Democrats, the New York Times recently noted that in 2003, “experts doubted that insurers would sell stand-alone policies covering only prescription drugs”—a new type of prescription drug coverage for seniors. By contrast, individuals can currently purchase a wide variety of health insurance plans—such that the rationale for a government-run fallback plan in the current legislative context does not exist.


•  Although enough private carriers have offered Medicare prescription drug coverage such that the fallback plan was never “triggered,” a provision in House Democrats’ health “reform” bill (H.R. 3200) would permit the government to take over the Medicare Part D plan. Specifically, Section 1175 of the bill would give the Centers for Medicare and Medicaid Services the authority to reject “any or every” bid by private Medicare Advantage plans and private Part D plans. This provision gives federal bureaucrats the power to eliminate privately-provided drug coverage entirely—for nothing more than the arbitrary reason that an Administration may wish to force tens of millions of seniors into traditional, government-run Medicare against their will.

Given that numerous leading Democrats have claimed that the so-called “public option” would lead to single-payer health coverage—a system which President Obama himself has endorsed—is there any doubt that the “trigger” mechanism would be written in a way to ensure the creation of a government-run health plan that, according to non-partisan estimates, would cause as many as 114 million Americans to lose their current coverage?