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editorial | AFTER OBAMACARE?

Some reforms to survive regardless of Supreme Court ruling

There was good news on the health care front recently. UnitedHealthcare, the nation’s largest health insurer, announced that regardless of what the US Supreme Court decides about Obamacare, it will maintain some of the law’s popular protections.

Specifically, the company said it will let parents keep adult children on their plans until 26; won’t impose lifetime limits on payments or drop coverage when someone is ill; and will still offer preventive health care services without co-pays. It will also keep the quicker appeals process the law requires.

Kudos to UnitedHealthcare for setting an example other insurers should follow. In this state, some already have. Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care, and Tufts Health Plan recently told the Globe that they will let young adults remain on their parents’ plans until 26 and will continue no-co-pay coverage of preventive services no matter what the high court decides.

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Yet even if all insurers followed UnitedHealthcare’s lead across the board, several large problems will remain if the court overturns Obamacare. One would be the ability to deny people health coverage based on preexisting conditions. As a practical matter, you can’t have such a ban without a requirement that everyone must carry health insurance; otherwise, people would simply go without coverage and opt in only when they become sick. That, of course, would undermine the very concept of insurance, which is to spread the cost of caring for the ill over a healthy population.

The requirement on insurers to cover people with preexisting conditions is popular, while the individual mandate is not. If more politicians acknowledged that you can’t have one without the other, it might well change the way people feel about that aspect of the law.