Consumer protections are lost in health-care debate

WASHINGTON (AP) — It’s one issue in the health-care debate that nearly everyone — even the insurance lobby — seems to agree on: Better consumer protections are needed to end the nightmare of not being able to get covered for a treatable, if costly, illness.

Yet such practical considerations are being overlooked in a debate that’s become a passionate argument about the government’s reach and role in medical matters.

Experts say the bills before Congress include significant consumer protections that would end denial or cancellation of coverage for medical reasons, from high cholesterol to cancer.

Insurers no longer could base premiums on a person’s medical history, although they still could charge more to 50-year-olds than to people in their 20s.

People buying their own policies, and those working for small businesses, would gain many of the advantages employees of Fortune 500 companies now have. That would eliminate “job lock,” the fear of leaving employment that provides medical benefits.

If President Barack Obama’s effort to remake the health-care system implodes, chances are slim that such protections could be enacted on their own. What consumer groups call discrimination by insurance companies, the industry sees as self-defense against people who put off getting coverage until they’re seriously ill.

Major insurers will accept a rollback of the industry’s restrictive practices only if they’re guaranteed that all Americans would be covered — a central goal of Obama’s approach and a potential financial boon to the industry.

The consumer protections are part of what Republican Sen. Mike Enzi of Wyoming calls the 80 percent of health-care fixes that there’s consensus for. Enzi is one of six members of the Senate Finance Committee who are trying work out a bipartisan solution — with no guarantee of success.

Obama may have made a critical error by not stressing the consumer aspects of the legislation, and his advisers seem to have realized it as they belatedly retooled the White House pitch in recent days.

If a bill does pass, the biggest winners are likely to be self-employed people and small-business owners and employees, who now have the most trouble getting and keeping coverage. Those working for big companies would only benefit indirectly; they’d find it easier to keep their coverage if they get laid off or leave to launch a new career.

Insurance companies could come out ahead, too.

One major catch is that the consumer protections would not be available immediately.