Wednesday, February 15, 2012

What's at issue in this insurance mandate debate?

Pithy, and to the point blog post that gets to the kernel of the insurance mandate brouhaha that has Catholics protesting. It asks two questions:

• Do religious-based organizations, such as Catholic hospitals and universities, and businesses owned by devout religious believers including Catholics, Evangelicals, Orthodox Jews, and Muslims, have the right under Obamacare to negotiate an agreement with an insurance company so that the insurance policy the employer offers to its employees does not include contraception, abortion, sterilization, etc.?

• Does an entrepreneur under Obamacare have a right to create an insurance company that in fact meets the needs of such employers?

If the answer to each is “no,” then Obamacare violates a fundamental right. If “yes,” then the problem is solved and the debate is over. But since the HHS regulations allow a narrow exemption for some religious organizations–e.g., churches, synagogues, mosques–that means that the answer to the questions is probably “no.”

I would add third and fourth questions:

Under this mandate, does an individual, say a retired or self-employed person that has moral or religious qualms about birth control, abortion inducing drugs, etc., have the right to negotiate coverage for him/herself that excludes such coverage?

The answer would seem to be ‘no’ given that no insurance providers are allowed to refrain from offering such coverage, (as question/bullet two from the post makes clear). They must provide these coverages “free” i.e., “without cost sharing” if they want to be in the insurance business.

So, it would seem that a group of say, one-hundred such folks as mentioned in the question cannot pool their resources and either become an insurance provider themselves, nor can they negotiate with an existent insurance provider to manage their pooled resources for such ends. They cannot do so IF they insist on excluding said services as covered. The mandate forbids this.

So, it’s not merely an issue of religious rights, but more broadly a question of what right government has to regulate voluntary associations and contracts of this sort. To see that it strikes not only at those of religious conviction, consider this related hypothetical:

Suppose there is a group of twenty-something year olds that would like to create a health insurance pool, basically providing themselves with minimal coverage (catastrophic care only). Would they have a right to do this?

It all depends on what the mandate mandates vis-à-vis minimal coverage doesn’t it?

Is that fair? Is it too intrusive? Is it constitutional?

Regulatory over-reach and micro-management brilliantly parodied by Iowahawk or the Onion


'Hold on to your lunch pail Ma: They cain’t read their own Regs!'

Did I say ‘parody’?
Nope. It’s real.
Hysterical must-read story.

Not-so-Sanka Freeze-dried version.

1. U.S. Department of Agriculture promulgates guidelines stipulating nominally nutritious meals for pre-schoolers.

2. The Division of Child Development and Early Education at the Department of Health and Human Services promulgates regulations that reflect (1), concerning meals served in schools.

3. Said regs require: one serving each of meat, milk, grain, and two servings of fruit or veggies. (Please notice the last requirement. If you’ve taken a logic class, you might see that it is possible to read it as requiring two each of fruit and veg, or as requiring two of one or two of the other. That first reading is a bit of a stretch, but it is possible. Keep it in mind.

4. If lunches do not supply all of these components, regulations require “supplementation.”

5. A “state employee” is tasked with inspecting ALL lunches in a classroom, to include brownbag lunches.

6. Brownbag lunches are lunches created at home by parents.

7. One girl’s BB lunch, upon inspection, was found to contain one turkey and cheese sandwich, one banana, one bag of potato chips, and a single apple juice.

8. The observant “state agent” deftly wielding the less plausible conjunctive reading of the reg, quickly inferred that the lunch did not meet the minimums set by the HHS-DCDEE regulation. It was apparent to the agent that the lunch lacked the two servings of veg.

9. The state agent leapt into action. Said agent supplemented child’s lunch by providing the child with an entire school-prepared lunch (to include two servings of veg).

10. Notice was sent to parent that brownbag lunches deemed insufficiently nutritious would be supplemented by the school, incurring charges to offending parental units. Mother, creator of illegitimate lunch, was billed a buck and a quarter for this particular contravention of said regulation.

11. Parental unit not pleased, writes school.

12. In said missive, parent defends said lack of veggies with the suspect “we do it at dinner, because we can get her to eat veg only under supervision” defense.

13. Principal informed of events by journalist, nonplused. Not aware this billing was going on.

14. When reached for comment, Department of Health and Human Services, Division of Child Development, Fiscal and Statutory Policy Manager, Jani Kozlowski, could not account for the action of the agent, nor for said agent’s conjunctive interpretation of the regulation. The manager, relying on an ‘inclusive disjunction’ reading of the applicable regulation, claims the lunch had met the “either two fruit or two veg” clause.

15 Manager Kozlowsi also could not account for the billing. Apparently unable to read the portion of the regulation that allows it, she remains baffled to this day.

16. That section of the regulation is helpfully quoted in full, in the journalist’s linked story.

The state regulation reads:

“Sites must provide breakfast and/or snacks and lunch meeting USDA requirements during the regular school day. The partial/full cost of meals may be charged when families do not qualify for free/reduced price meals.

“When children bring their own food for meals and snacks to the center, if the food does not meet the specified nutritional requirements, the center must provide additional food necessary to meet those requirements.”

17. Persistent in her state of befuddlement, Kozlowski insists the parents shouldn’t have been charged.

{And you thought the “agent” couldn’t read?}

18. Marvel further at Koslowski’s deft inferences as to the possible motivations of the school, the “agent” and possible remedies she may be able to bring to bear on this sorry state of affairs:

“The school may have interpreted [the rule] to mean they felt like the lunch wasn’t meeting the nutritional requirements and so they wanted the child to have the school lunch and then charged the parent,” she said. “It sounds like maybe a technical assistance need for that school.”

“Technical assistance” indeed.

But, every time I call ‘tech assistance’ I get some guy from India whose name is Paul, and can understand only a few things he says.