Astonishing remarks by lawmakers and even more evidence that there needs to be set of basic facts that are understood by all lawmakers before they start debating. Below is an expert’s explanation of how insurance works. This lawmaker is demanding that the “consumer” choose what best suits his needs and so should not have to pay for prenatal care. He is assuming, of course, that men have no responsibility for the bearing of children. I hope his views on abortion reflect that lack of responsibility and care. Is this lawmaker really suggesting that only women should pay for prenatal care?
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Here’s how insurance expert and columnist Nancy Metcalf answered a similar question from a Consumer Reports reader that year:
Health insurance, like all insurance, works by pooling risks. The healthy subsidize the sick, who could be somebody else this year and you next year. Those risks include any kind of health care a person might need from birth to death — prenatal care through hospice. No individual is likely to need all of it, but we will all need some of it eventually.
So, as a middle-aged childless man you resent having to pay for maternity care or kids’ dental care. Shouldn’t turnabout be fair play? Shouldn’t pregnant women and kids be able to say, “Fine, but in that case why should we have to pay for your Viagra, or prostate cancer tests, or the heart attack and high blood pressure you are many times more likely to suffer from than we are?” Once you start down that road, it’s hard to know where to stop. If you slice and dice risks, eventually you don’t have a risk pool at all, and the whole idea of insurance falls apart….
Before the new health law took effect, insurers can and did exclude maternity coverage from individual plans. In fact, in half of states you can’t purchase maternity coverage on the individual market for any price. In most of the rest, you can buy a maternity rider on your policy. In many cases it costs more than the main policy itself, and you can’t use it for at least a year after you buy it, and it often has a separate deductible of up to $5,000.
Why so expensive? Because the only people who buy it are, naturally, people planning to have a baby. Insurers know this and price accordingly.
