MedLaw: The Un-insured soon to become The Under-insured

I've been worried recently about so called "conscience clauses" that allow insurers to refuse to cover services they find ethically objectionable--abortion, birth control, in vitro for gay couples. You might ask, why can't insurers do that already when they setup a plan? Well, most states have laws (and under the federal rubric of division of powers states get to regulate insurance) that mandate minimum coverage. Well, now Congress has decided that states aren't acting fast enough to undermine citizen protections and have proposed legislation to allow businesses and insurers to refuse to cover services for pretty much any damn reason they want (who needs religious outrage?). And their argument: By lowering what insurers can offer, more people will be insured.

Sponsor Sen. Mike Enzi R-Wyo. predicts that most businesses will stick with the policies they currently offer rather than switch to a less comprehensive benefit and only those businesses without any coverage would choose to add the crappy coverage. (Remember to downplay the number of employees that are being screwed and the number of businesses that will make money off this act of betrayal whenever you are proposing legislation to allow businesses to screw their employees.)

And the best part is, this bill is merely an attempt to cover the uninsured: "They have no insurance right now, so this would be an improvement," Enzi said. This is a great solution, when presented with a huge number of people who don't have health insurance (and thus don't have access to basic services) just redefine what constitutes a basic service.

Insurers say the state mandates (such as mammograms, immunizations, and child health exams) are driving up the cost of policies, and the ranks of the uninsured. Additionally, some states have increased the age at which insurers must cover unmarried dependents to 25 and 30 years old. Why are they doing this? Perhaps it's because so many of those unmarried dependents are (you guessed it) uninsured.

Forty-six states also require coverage for treatment and screening of diabetics, as well as the cost of their insulin. First of all, which four states DON'T require coverage for insulin? And, as Lawrence Smith, president of the American Diabetes Association points out, "The need for diabetes care will not diminish simply because coverage shrinks . . . it will be our emergency rooms and Medicaid system that are forced to pay, thus overburdening an already strapped public health infrastructure."