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This site is the inspiration of a former reporter/photographer for one of New England's largest daily newspapers and for various magazines. The intent is to direct readers to interesting political articles, and we urge you to visit the source sites. Any comments may be noted on site or directed to KarisChaf at gmail.

Wednesday, January 15, 2014

ObamaCare's Sex Problem -- By James Taranto, The Wall Street Journal

The official ObamaCare "enrollment" numbers are out, and they're very close to the unofficial estimates on which we based yesterday's column arguing that the "adverse selection" problem does indeed seem to be materializing. That's based on the age breakdown, which shows ObamaCare failing to attract the required proportion of younger Americans (18-34) and skewing heavily toward middle age, especially late middle age.

It can't be stressed enough that the real story is almost certainly far worse than the age distribution would suggest. The reason the age distribution is important is that younger people tend to be healthier, meaning that they consume less medical service and are cheaper to insure. But some young people are sick too, and if they are the ones buying ObamaCare policies, that aggravates selection despite their tender years. But while this problem can be identified and anticipated, there is no way to estimate its magnitude. Insurance companies no longer ask about pre-existing conditions.

A Wall Street Journal news story points to another potential source of adverse selection:
[Texas insurance executive Allan] Einboden added that age offered only a partial insight into the kind of medical claims new customers might incur.
"If you had a lot of people who were in the 18-34 [age] group because they were planning to have a baby, that would be a very negative demographic as well," Mr. Einboden said. The health plan hasn't yet begun receiving claims, he said, though several requests to preauthorize surgeries in the first days of coverage have executives worried, he added.
Which brings us to a little-noted ObamaCare statistic that is also a sign of adverse selection: the sex ratio.

One of the selling points of ObamaCare was that it was a feminist triumph. "Being a woman is no longer a pre-existing condition," read the lead sentence of a March 2010 news story in the New York Times, whose author, Denise Grady, then explained: "That's the new mantra, repeated triumphantly by House Speaker Nancy Pelosi, Senator Barbara A. Mikulski and other advocates for women's health. But what does it mean?"

What it means, in Grady's words, is that "the new health care law forbids sex discrimination in health insurance." Just as no one can be denied insurance or charged more because of a pre-existing condition, a woman and a man of the same age must be charged the same premium, and their policies must cover the same conditions--including maternity care for unmarried men (and women past childbearing age). 

What it also means, however, is that women, like persons with pre-existing conditions, are more expensive to insure. The ban on what is called "gender rating" drives men's premiums up as well as women's down. (That doesn't mean, by the way, that women pay less under ObamaCare than before. It may be that premiums rise for both sexes but the increase is steeper for men.)

 It means, further, that if ObamaCare enrollees are disproportionately female--just as if they are disproportionately older--premiums will tend to go up for everybody. And lo and behold, they are: The Department of Health and Human Services reports that of the 2.2 million people who have "selected a Marketplace plan," 54% are female. "By comparison," the HHS report helpfully notes, "males account for half (50 percent) of the total non-elderly population in the United States (ages 0 to 64)."
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