Gallup: Support for Obamacare slipping

[Franzl]

How far do you take that principle of equality, though? Should insurance companies not be allowed to use any statistical methods to determine rates for various people? I suppose you could mandate that everyone pay exactly the same premium in the interests of fairness, but I don't think that would be particularly fair, either. Why should, say, someone that smokes 3 packs a day not be considered a higher risk?

(Note that I support publicly funded healthcare. But if you're going to have private insurance companies, not allowing risk assessments seems like an odd idea.)

[7,052,770]

How far do you take that principle of equality, though? Should insurance companies not be allowed to use any statistical methods to determine rates for various people? I suppose you could mandate that everyone pay exactly the same premium in the interests of fairness, but I don't think that would be particularly fair, either. Why should, say, someone that smokes 3 packs a day not be considered a higher risk?

(Note that I support publicly funded healthcare. But if you're going to have private insurance companies, not allowing risk assessments seems like an odd idea.)

Starting in 2014, there are only 4 factors an insurance company can use to vary people's rate: 

• Age - the most expensive age (64 usually) can only be 3 times as expensive as the cheapest age (18 usually). Before the ACA, 5x was common, or sometimes more.  In some states, 3x or less was the law already.  I have no objection to this -- in New York, age rating was completely against the law, and it created a runaway adverse selection problem that only like 50,000 people in the entire state bought individual insurance, so we've definitely got to keep allowing age rating.
• Family size - For a family insurance plan, you can charge more for families with more people in them.  Technically, you can charge for all adults and up to three children below 18.  This is fair and obvious (I don't think anyone would advocate "all families pay the same rate, regardless of how many kids they have or don't have!"
• Geographic location - because each area has a different set of hospitals and doctors that insurance companies negotiate different rates with.  I'm neutral on this one; I wouldn't object if it were removed, but I understand why it's in there.
• Tobacco status - you can charge smokers up to 1.5x what you charge non-smokers.  I'm as fiercely anti-tobacco as anyone, but I think this should be removed.  There are all kinds of stupid self-destructive behaviors out there, and it's not fair to single out smokers.  Alcohol, illegal drugs, unprotected random sex, daredevil stunts, etc., don't cause people to pay higher rates, so neither should tobacco.  Plus, the definition of "smoker" is someone who smokes 4 or more cigarettes per week for reasons other than religious purposes, and insurance companies cannot require proof of non-smoker status, so smokers can just lie and get away with it anyway.

Insurance companies can not use any other reason to charge people different rates.