HIMMAA: A Non-Solution for America’s Health Care Crisis


Congress is once again trying to address a very real problem with ill-conceived legislation certain to do more harm than good: The Health Insurance Marketplace Modernization and Affordability Act (“HIMMAA”, or S. 1955).

The problem? The inability of small businesses to afford health insurance. Congress’s solution? Allow insurance companies to discriminate against employees based on everything from how old they are to where they live and take away state protections that guarantee coverage of basic health care services. Makes a lot of sense, doesn’t it?


Here’s the deal: the guiding principle of this complex legislation seems to be that it is better for most people to get next to nothing than for many people to get insurance that is actually worth something. In exchange for making insurance available to more people, the bill exempts many health insurance plans from critical state mandates, including guarantees of benefits that states deem critical, such as coverage for cancer screenings and treatment, diabetes supplies, mental health, preventive care, rehabilitation, well-child care and immunizations, maternity care, and contraception. Twenty-four states currently have laws requiring that insurance companies cover birth control if they cover other prescription drugs. Passage of this bill could stop that progress in its tracks.

Along with offering sub-standard insurance plans of no real benefit, HIMMA would also make it much more expensive for currently insured groups to retain affordable comprehensive coverage. The bill would allow insurance companies to sidestep state consumer protections against discrimination, allowing the industry to set higher rates for women, the elderly, those who are or have been sick, or even people who live in rural areas. The inevitable result, of course, is that companies with older or sicker workers will face much higher premiums that will either have to be passed onto the worker or will simply make insurance unaffordable altogether. It is not hard to imagine a day where questions like “Have you ever had cancer?” or “Do you live within 15 miles of a hospital?” become a routine part of job interviews in an effort to keep insurance costs down. It is equally easy to imagine a day where small businesses simply won’t hire any worker over the age of 50, all in the name of maintaining the meager insurance the company is able to offer its employees.

Congress is trading quality for quantity, the result being a net loss for all of us. Who is the real beneficiary of this arrangement, you ask? You guessed it: the insurance industry, who will be able to charge higher premiums to more people for substantially less service than it provides now.

Which leaves us to ask, why is Congress offering us so much less than it demands for itself? The cynic would say it is because they don’t care, since they will never have to live under the policy they’re selling. Yet maybe it is simply that Congress just doesn’t get it. Maybe Congress doesn’t get that calling someone “insured” is not the same as giving someone insurance. Maybe Congress doesn’t get that if this bill passes, all we will have are “bare bones” insurance plans that are little better than two aspirin and a band-aid, wholly inadequate to cover most of the ailments which you need insurance for in the first place. Maybe Congress doesn’t get that S. 1955 is nothing but an empty promise and an illusion of security at a time when real, workable solutions are needed to address the nation’s health care crisis.

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