Gaming the New Rules of Health Insurance

Money & Ethics

Gaming the New Rules of Health Insurance

People who can afford insurance but choose to go without it are thumbing their noses at society.

Q: My son is 27, and his employer, a small tech start-up, doesn't offer health insurance. The company has fewer than 50 employees, so under the new health-care law, it won't have to provide health coverage.

My son can't go back on my husband's employer-paid policy because he's past the age limit of 26. He makes good money, about $50,000 a year, but says he has no intention of buying individual health insurance -- not even a catastrophic policy that would kick in if his medical bills were to get too high.

My son figures he can always get insurance through one of the new high-risk pools if someday he gets really sick and needs it. And he points out that he won't face a personal penalty for not having insurance until 2014, when it will likely be a painless $500 -- a lot less than the cost of an individual policy.

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I feel it's unethical of him to game the system this way. What do you think?


I agree with you. Your son is doing well enough financially to take responsibility for his well-being by buying his own coverage, which he may find quite affordable (see Health Reform, Phase I: What You Will See When). I also believe that his employer, regardless of its exemption from the new employer-coverage mandate, should find a group policy that both the company and its employees can afford. But that's another issue.

Who does your son think should pay the bills for his unforeseen medical needs? You and your husband? The local hospital that treats him after an auto accident? A health insurer to whom he hasn't paid any premiums before his need arose? A government agency? Or is he planning to save enough money to handle the bills himself? People who can afford all kinds of insurance -- health, life, disability and so on -- but choose to "go naked" are essentially thumbing their noses at their families and society.

Send your own money-and-ethics question to Editor in Chief Knight Kiplinger.