There are some interesting conversations occurring with respect to healthcare, and I think many people don’t quite understand the parlance that is being used in those discussions. When you don’t understand the meaning of the words being used, it’s difficult to understand the speaker.

Since before its passage, Republicans have been taking about repealing the Affordable Care Act, commonly known as Obamacare.  Obamacare seeks to offer private health insurance to all Americans by pooling younger populations of insured individuals with older individuals and by supplementing poorer individuals’ health insurance through an expansion of the Medicaid program.

Because of Obamacare, approximately 20 million Americans who did not have health insurance now have health insurance.  The uninsured rate in this country is at an all-time low of approximately 9%.

Under Obamacare, insurance companies must offer policies of insurance that provide certain benefits.  The insurance policies provide comprehensive insurance coverage to all insureds.  In addition, insurance companies cannot deny you insurance because of a pre-existing condition, and children are entitled to remain on their parents’ health insurance until they attain the age of twenty-six.

Republicans have offered several solutions for when they repeal and replace Obamacare, as they have promised to do.  These proposals include health savings accounts, tax credits for premium payments paid, greater coverage options (the right policy for the insured) and the ability to obtain insurance “across state lines.”

A health savings account is an account into which an employee can place his money pre-tax.  The worker does not pay tax on the money he contributes to his health savings account.  A tax credit is a dollar-for-dollar reduction in taxes.  I like both of these solutions.  I pay income tax and I pay for my health insurance.  If the federal government wants to allow me to save more money tax free and to reduce my taxes on a dollar-for-dollar basis on the premiums I pay, I think that’s terrific.

The problem for 45% of the United States population is they don’t pay income tax.  So health savings accounts and tax credits do absolutely nothing for approximately half the population of this country.

What are “greater coverage options” or the “right policy for the right person”?  I have heard a Republican strategist ask the rhetorical question, “Why should a 25 year old man’s health insurance include coverage for a mammogram?”

Indeed, a 25 year old man probably will not need a mammogram.  While men do get breast cancer, it’s relatively rare.  Woman don’t get prostate cancer as far as I know, so I guess they shouldn’t pay for health procedures associated with the prostate.  Most younger people could probably get away with health insurance that covers very little and has higher deductibles.  And for this minimalistic coverage, they should pay very low premiums.

The problem though is two-fold.  One, when people (young or old) begin picking insurance that covers this procedure but doesn’t cover that procedure, they might as well flip a coin because none of us knows what tomorrow might bring.  None of us know what coverage we might need.  Two, if most younger people buy cheap, minimalistic insurance, then older people (who see doctors more frequently) are going to pay much more for their insurance.  And while younger people might say “that’s their problem,” the thing is, being healthy leads to getting old, so one day soon they’ll be looking for insurance when they actually need it.

“Buying insurance across state lines” means that New Jersey regulates what policies of insurance an insurance company can issue.  New Jersey might require insurance companies to offer good policies of insurance.  But, for example, Minnesota might allow insurance companies to offer very minimalistic policies of insurance.  Right now, a New Jerseyian cannot buy a policy from Minnesota, but maybe someday soon they will be able to buy a cheap, minimalist policy from a Minnesota insurance company.  The person will have insurance, but it won’t cover much.