Many of us have been wondering whether it's possible to have an honest, reasonable debate about Obamacare. To my pleasant surprise, one may finally be starting.
It's about the same subject that got me all worked up early this week: Whether Obamacare will cause "rate shock" among people buying insurance coverage on their own, through the new insurance exchanges. And if you pay attention to the right people, you'll discern a basic consensus about the facts.
The consensus goes like this: Some people buying coverage on the exchanges will pay more for insurance than they do today. Some people will pay less. The benefits will be better and the policies will be more widely available, but those changes require their own trade-offs, like forcing some people to get more coverage than they want. The insurance offerings from California—the announcement that set off this debate—were better than most of us were expecting. But the numbers in other states could look a lot worse.
Among these writers, who span left and right, plenty of disagreement remains.1 Is it fair to ask some young and healthy people to pay more for their insurance? How will the people who see higher premiums react? What will that reaction do to the system as a whole? But, as The Daily Beast's Megan McArdle put it, these questions are in many ways more "theological" than "technical." They come down to values and to predictions that, at this early date, are simply impossible to confirm.
Still, I think many Obamacare critics and quite possibly some of its supporters don't fully grasp the significance of one key factor: the subsidies.
To review: Obamacare reorganizes the market for people buying coverage on their own, so that they are no longer at the mercy of insurers who pick and choose the healthiest customers. This "non-group" market is pretty small, in relative terms: The vast majority of Americans will continue to get insurance from employers, Medicare, or Medicaid. But for insurers who sell non-group coverages, the rules for conducting business are changing dramaticaly. Under Obamacare, these insurers must provide all beneficiaries with a core set of benefits, for example, and they can't deny coverage to people who have pre-existing conditions. Insurers are reacting to this by raising premiums. They really don't have a choice, since they can no longer skimp on benefits or avoid taking on sick people.
If you want to make Obamacare look really bad, you stop telling the story right thererest http://www.newrepublic.com/article/113392/obamacare-rate-shock-debate-subsidies-make-huge-difference?utm_campaign=tnr-daily-newsletter&utm_source=hs_email&utm_medium=email&utm_content=8998371
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