Congratulations to Jimmy Kimmel and his family, who welcomed William "Billy" John Kimmel on April 21. Jimmy Kimmel's moving monologue on the birth of his child has already accrued more than 1 million views. Just hours after Billy's birth, a nurse noticed two serious heart defects, and an amazing team of healthcare providers treated Billy, saving his life.
I love watching Jimmy Kimmel, and having just welcomed my first child last year (and having a husband who works in healthcare), his story really hit home. It's truly every parent's worst nightmare. Thank God for the happy ending in this case.
Unfortunately, some folks are using Kimmel's story as fodder in the debate over Obamacare. Kimmel himself made some statements worth addressing. He said:
We were brought up to believe that we live in the greatest country in the world, but until a few years ago, millions and millions of us had no access to health insurance at all. Before 2014, if you were born with congenital heart disease like my son was, there was a good chance you'd never be able to get health insurance because you had a pre-existing condition. You were born with a pre-existing condition. And if your parents didn't have medical insurance, you might not live long enough to even get denied because of a pre-existing condition.
If your baby is going to die, and it doesn't have to, it shouldn't matter how much money you make. I think that's something that, whether you're a Republican or a Democrat or something else, we all agree on that, right?
First, yes, I think we can all agree that a newborn life is worth saving, no matter who is going to pay for it or how. (Interesting side note: Even before Obamacare, health outcomes were more strongly tied to income in Canada than in the United States.)
The U.S. truly is the greatest country in the world, with the greatest healthcare available. Our health insurance markets, on the other hand, need reform. They needed reform in 2010, when Obamacare passed, and they still need reform now.
Anyone who has welcomed a new baby knows that you have 30 days to add a new son or daughter to your health insurance plan. This was the case before Obamacare, and it's the case now. What many people may not know is that, even before Obamacare, insurance companies added newborn infants at standard rates, regardless of their health condition, because of guaranteed renewability laws.
Presumably, Kimmel and his wife have a health insurance plan, and they added Billy as soon as he was born. Obamacare likely had no effect on their case.
If parents did not add their children to their insurance within 30 days, however, then insurance companies could charge higher premiums, perhaps unaffordable ones, for children (or adults) with pre-existing health conditions.
This practice of risk-rating insurance products may be politically unpopular, but it encouraged people to buy insurance before the fact and maintain continuous coverage. When Obamacare outlawed this practice, many healthy people left insurance pools, leaving insurers with higher claims and financial losses, causing them to exit the exchanges, leaving fewer options and even higher prices. In other words (the words of Aetna's CEO), it became a "death spiral."
It's worth pointing out that before Obamacare, for uninsured people with pre-existing conditions, there was a safety net. For those who couldn't get affordable coverage in the market, many states offered high-risk pools, and others offered plans of last resort. Medicaid was also an option in all 50 states, with varying eligibility rules.
These protections were not always perfect in practice. Sometimes people were wait-listed. Often people faced a temporary exclusion for claims related to their condition. The system was not always clear and easy to navigate. Medicaid didn't (and still doesn't) provide access to the very best care.
But one has to wonder, what if we had worked to improve this safety net, rather than pass Obamacare? Could we have struck a better balance between protecting pre-existing conditions and fostering a competitive, low-cost insurance market?
Kimmel likely gets his insurance from his employer (most Americans with private insurance do). This means that if he were to lose his job, he (and his son) could lose insurance. This was the case before Obamacare, as it is now.
The Health Insurance Portability and Accountability Act of 1996, while it did provide some protection for people moving from the group market to an individual plan, was really a patch for a complicated system that centers around employers due to the serendipity of history (and some stupid laws). WWII-era wage controls encouraged the offering of on-the-job insurance benefits, and Congress exempted employer insurance plans from taxation.
A better, more fair system would not center around employment, because then Americans would not have to fear losing insurance when losing a job. Real health reform would focus on dissolving this link by giving people who buy individual insurance the same tax advantages to those who get insurance through their employer.
In conclusion, Kimmel is right about some things, and not exactly right about others. America is indeed the greatest country in the world. Free enterprise has fostered incredible innovations in care that save lives like Billy's. Teams of health professionals in hospitals across our country work hard every day to care for patients without regard to their ability to pay. God bless them.
We shouldn't use stories like Kimmel's to imply that anyone who opposes Obamacare is content to watch sick newborns go without insurance coverage or access to life-saving healthcare. No parent should have to watch his or her child suffer. No one, regardless of politics, wishes that on anyone else. I'm glad Kimmel was gracious enough to recognize that. Let's hope others follow his lead.
But the policy debate is real. Obamacare isn't the best solution. It's certainly not the only solution. There are other, better health reform solutions that would improve the world of health insurance for people like Jimmy Kimmel and millions of others.