Risky Business

When Nancy Pelosi said “we have to pass the bill so that you can find out what’s in it” she wasn’t kidding! Four years later the adventure into this 906-page behemoth continues. Apparently taxpayer funded bailouts of insurer losses is one little tidbit they tried to sweep under the rug. This provision is part of the innocuous sounding “Section 1342. Risk Adjustment.” This section of the bill is intended to insure the insurers against their own bad decisions. This is achieved by compelling all insurers to participate in the “risk corridor” program. This program requires them to fork over progressively larger portions of what the government deems to be “excess profits” to offset any “excess losses” by their competitors. The idea is that robbing Peter to pay Paul will keep the program revenue neutral. This neutrality rests on the dubious assumption that the distribution of excess funds from company A will always offset the deficit from company B. Even if that assumption were true, the goal here is flawed. This program will engender a government run cartel of insurance carriers with zero incentive to reduce costs. Too efficient? Make too much? Sorry, we’re gonna’ give it to your competitor. The insurance industry essentially becomes a single federalized fascist monopoly; administered by the federal government but held by private entities. The veneer of private ownership in name only is maintained only to fool the “useful idiots” into believing we still have a “free” market.

Even if one is a proponent of Obamacare, it should be recognized that this provision will do more harm than good in terms of reducing cost. In fact it will have the opposite effect: it will drive the best insurers out of business while subsidizing the worst, thus ensuring ever-increasing costs. Only free competition can have the correct effect: drive the worst out while rewarding the best. Any well-run business maintains capital reserves from flush years to offset potential future losses in lean years. In other words a well-run business will take care of itself. Forcing such a business to hand over its reserves to its more profligate competitors and expecting those prodigal siblings to change their ways is naïve at best, willfully ignorant at worst. But wait, there’s more!

As is typical for such bills there is an underlying assumption that nothing could ever go wrong, therefore it lacks any provision to cap how much the feds may have to dole out under this program. In other words the American taxpayer will be obligated to write an unlimited blank check to cover health insurance industry losses (the program is slated to only run from 2014-2016, but you can be certain industry lobbyists will ensure it is renewed in perpetuity). The moral hazard arising from this program will incentivize insurers to steal business away from their competitors by undercutting them on premium. The better-run insurers won’t cut as far and will lose customers; the more poorly run insurers will cut deeper (counting on a bailout if they go too far) and gain customers. Eventually, once the more prudent insurers are all out of business, all that will remain will be the insurers counting on their annual bailout. There is no free lunch. Premiums may decrease on the front end, but when April 15 rolls around or your inflation riddled dollar buys you less, you’ll be paying it on the back end (I leave it to the reader to decide if that metaphor is figurative or literal).