Consumers Set to Repeal a Big Part of the Health Care Law

Most stories about the president's health care law these days are about the challenges of implementation and the complexity of setting up exchanges. But that's not where the action is.

What's more important is that insurance companies, benefits consultants and others are actually reading the 2,000-page law to see what it says.

Perhaps the biggest news came last week when The Wall Street Journal reported that the mandates for comprehensive coverage apply to just 30 million out of 160 million Americans with private insurance: "A close reading of the rules makes it clear that those mandates affect only plans sponsored by insurers that are sold to small businesses and individuals, federal officials confirm."

Companies can avoid many of the financial penalties by offering only minimal insurance coverage costing as little as $40 a month. It doesn't mean they will all offer such skimpy coverage, but there's a lot of flexibility between those skinny plans and the very high cost of meeting the mandated coverage requirement.

Earlier, The New York Times had reported that there was another way around the mandates: "Companies can avoid many standards in the new law by insuring their own employees." Government regulators are busily trying to stop companies from taking that option.

Still, the law as written forces very few companies to offer the comprehensive coverage that President Obama envisioned. There will be little public pressure to change that. The debate is no longer about whether the government or insurance companies select an individual's insurance coverage. Now, it will be decided by consumers.

Most Americans recognize that there are natural trade-offs in the health insurance debate. Seven out of 10 believe that as the cost of providing insurance goes up, companies are likely to offer smaller paychecks to make up the difference. A similar majority believes companies also will respond by hiring fewer workers.

A key premise of the president's plan is that people will want the gold-plated insurance coverage they tried to mandate, but advocates of the plan dramatically misread the public mood. Only 28 percent of voters believe the top priority should be guaranteeing comprehensive insurance coverage for all workers. Sixty-six percent think it's more important to let workers pick their own mix of insurance coverage and take-home pay.

If they had a choice, 59 percent would choose a less expensive health insurance plan that covered only major medical expenses and a bigger paycheck. Even a majority of those in the president's party would select that option.

Just to be clear, everyone would still have high quality insurance. Some, though, would pay for routine office visits out of pocket and use their insurance just for the big and unpleasant surprises that sometimes come our way. They'd be able to afford it because their paycheck would be bigger each week. Others would opt for the security of having everything paid for by their insurance company.

In that environment, employers will compete to find the best mix of pay and benefits needed to recruit good employees.

As consumers opt for less coverage and more take-home pay, they will effectively repeal a major portion of the president's health care law.

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