The Case against John Kerry's Health Plan

Study | Health

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No. 269

Friday, September 10, 2004

by John C. Goodman & Devon M. Herrick

Incentives to Be Uninsured

Kerry’s plan to create an FEHBP-type system for individuals is supposed to reduce the number of uninsured by almost 6.7 million. Yet depending on how it is structured, it could cause the number of uninsured to increase. The reason: Many employers may simply drop coverage for their workers knowing that they can buy into the managed competition system. Workers facing premiums on their own without the tax exclusion granted to employer plans may opt to do nothing until they need care. In addition, if the system is structured like the federal program, people would be able to enroll annually at community-rated premiums. This means that people could avoid paying premiums while they are healthy and enroll only after they get sick. If healthy people respond to these incentives in predictable ways, the number of uninsured will rise, not fall.