In which GOP Sen. Pat Toomey compares human beings to burnt-out houses.

Shout-out to Amy Lynn Smith for capturing this exchange between Republican Senator Pat Toomey (PA) and HHS Secretary Nominee Rep. Tom Price (GA):

SEN. TOOMEY: “Now, one way to force it is to force insurance companies to provide health insurance coverage for someone as soon as they show up, regardless of what condition they have, which is kind of like asking the property casualty company to rebuild the house after it’s already burnt down.”

Now, aside from the obvious callousness of this statement, there's a couple of important problems with his comparison:

  • If you rebuild a house after it burns down, it's not the same house. It's an entirely different house. Pretty sure no human beings want to simply be "rebuilt" by being replaced with an entirely different person.
  • This is why the ACA exchanges are supposed to have a limited enrollment period window; you can sign up during that window, but not outside of it except for special cases. In other words, people aren't supposed to simply be able to walk in off the streets and sign up after they've been diagnosed with cancer/etc (unless that diagnosis happens in the middle of open enrollment anyway). This is nothing new or unusual--most large group plans have had a narrow time-limited window for decades, as does Medicare...and in fact, that's usually a much narrower time window: October 15 - December 7 for Medicare, for instance.

Now, it's true that there have been claims of major problems with people taking advantage of those "special circumstances" (Special Enrollment Periods during the off-season), but that's an enforcement and verification issue. HHS has supposedly cracked down on verification of SEPs (requiring documentation, etc), and perhaps they should tighten up still further on them. In addition (assuming the ACA stays in place after all), starting in 2019, the Open Enrollment Period itself is scheduled to be cut in half:

In the Benefit and Payment Parameters for 2017, HHS confirmed that they will maintain this same November 1 to January 31 open enrollment period for 2018 coverage as well (ie, open enrollment for 2018 coverage will begin on November 1, 2017 and will end on January 31, 2018).

But after that, for coverage effective in 2019 and beyond, open enrollment will be shorter, and will end before the start of the coverage year. It will run from November 1 to December 15, with coverage effective January 1.

Louise Norris makes a couple of excellent additional points:

So much needs to be said here. For starters, this is why mortgage companies require buyers to maintain homeowners insurance.

— Louise Norris (@LouiseNorris) January 25, 2017

While we're on the burning house analogy, the government has also ensured that everyone has free access on fire departments.

— Louise Norris (@LouiseNorris) January 25, 2017

Say, maybe that's the solution! Instead of single payer health insurance (being paid out to private doctors/hospitals), how about flipping it around? Have all the doctors/hospitals work for the government at a more reasonable pay scale (aka "socialized medicine"), but keeping the insurance to pay them in the private sector (while also keeping it heavily regulated)?

Anyway, none of this changes the fact that Pat Toomey is a jackass.