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It's being reported that Dianne Barrette is losing her coverage and being put on a more expensive plan.  For background see here:

We can see from the video that Dianne Barrette has "GoBlue plan 91".  This is a 'limited benefit' plan.  It is widely understood that these plans are not replacments for comprehensive health insurance plans, and it's easy to see why.  If Ms. Barrette incurs $30,000 worth of medical care, the plan will pay somewhere between $50 and $500 depending on the services.  There are two things you get from these plans:  a provider to negotiate down rates for you, and a small amount covered by the insurer themselves.  You can see the supporting documentation for this plan here:

It's no wonder her new plan from BCBS is 10 times more expensive, as it is a comprehensive plan.  I'm not sure if she is aware of these coverage limitations, but let's assume she is. She rightfully asks why she can't keep this plan, and this gets bring up some interesting issues of health care in America.

I, personally, don't think it's smart to go without insurance.  She certainly won't be able to pay for some services, and could end up dying because she doesn't have insurance.  But maybe that's a risk she's willing to take.  Her preference for a given level of risk-aversion is something I wouldn't argue against.  However, there is chance that she might end up in a situation in which she will need care that she will not be able to pay:

One of the arguments for why people should be mandated to purchase insurance is because they will almost certainly use medical care some time in their life and hospitals will almost certainly be required to provide care to at least stabilize a patient. The argument is that individuals should not be allowed to offload (externalize) risk onto others.  After all, if I can't pay, you and the hospital will, so why not let someone else shoulder that risk? (So the strategy goes.)  Now whether one buys the moral argument in this case or even the legal one, the economic one is almost obvious.  But this argument applies not just to the insured, but to the under-insured.  She may, depending on how wealthy she is, be offloading risk to the general population: after all, they'll pay if she can't.  

But what if there are people whose premiums increase under the ACA that are comprehensive plans?  It is said the reason that capitalism is a great system for finding efficient optimal equilibria (supply v. demand, wages v. labor, etc).  We need to take note of the optimal outcome that the efficient market has provided as it may conflict with our moral obligations.

Insurance companies currently have small risk-pools with healthy people in the individual market (or just sick enough to find the revenue sweet-spot).  This allows healthy people to benefit from their health in the form of smaller premiums.  Now when a sicker person enters the risk pool, the premiums go up for others.  The government is trying to expand the risk pool to include as many people as possible.  There is an economic benefit to this goal as larger risk pools have, on average, have lower premiums.  However, some people might see their plans increase relative to the case in which there is a very tight risk pool.  If you and I are genetic miracles and Olympic athletes that decide to live indoors for the next year, maybe an insurance company will offer both of us plans for a dollar, but why should the benchmark of the cost of our plans be these small risk pools?  Surly some people are sick because of chronic conditions based on decisions, but not only can we change the law to do something about these people if it was that bad, but the majority of preexisting conditions are not due to personal decisions.   It seems that the health care debate is derivative on that more egalitarian debate: why should we order a society in a way that favors the lucky (rich, great parents, genetically superior), over one that is more just (insuring people a decent shot in life)?  I am well aware of the defficient entitlement/liberty arguments from the libertarians (no need to hash that out here), but insofar as someone's comprehensive plan does increase under the ACA, let's understand that part of it is for reasons of fairness.  Why should the healthy pay less than the sick who are sick due to factors beyond their control?

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