Ok, the President Lied* About Obamacare
Did we think it was going to be easy to craft a major change like the ACA?
And if we did nothing, what then?
Without the ACA (Obamacare) we would have ever more folks without insurance, as employers continued to drop group health insurance and others shifted more and more work to contractors who don’t get benefits.
And for folks over 50, well if you lost your job and benefits, any health insurance you could find was probably very expensive – and if your health was poor, unavailable.
Young folks may not realize just how many family decisions are made based upon whether a spouse has health benefits or not. For many couples where one is a contractor, the other keeps a shitty job because he or she receives health insurance as an employee benefit. This need to find and keep health insurance functions as a “tax” on behavior and creativity.
Any move to a national health insurance, would have needed extra money from somewhere. Had we gone to a single payer system, the money would have come in the form of a new tax (or been unfunded). Since the ACA relies on private health insurance, much of the new money comes from the new insurance customers, whose premiums amount to a new source of revenue to fund health care. There is also a new tax, the excise tax on Cadillac plans. How a plan is deemed too generous (and thus a Cadillac plan is tricky) but however the details worked, the ACA necessitated more money from someone. In this case, the new money comes from insurance customers and from employers.
So… what lies did President Obama tell?
The first lie was about cost. Sorry, the president understated the price tag. Your health insurance will probably cost more than your cell phone bill. Though not necessarily more than your cable and cell phone and data plan combined. And there are juicy subsidies for folks who earn less – so for them; maybe their net cost will be close to what the president stated. (So maybe he didn’t lie at all!)
He also was wrong to say that everyone who has insurance will be able to keep it. Not true.
Many individually sold plans are not compliant; these will be cancelled. For example, many have relatively low lifetime maximums, or carefully worded restrictions – so that if you got cancer (for example) you might exhaust your benefits on one year. Yep, nothing left after your one big illness. Sadly, you wouldn’t know till too late. So the ACA makes things better. But better costs money.
A few plans are grandfathered, but the issue of cancelled plans is turning out to be bigger than predicted. And more expensive. But the one thing that is true is that, in the end, you will always have coverage for major illnesses under an ACA compliant plan.
Employers are also making changes to avoid the excise tax for Cadillac plans. Yep, even though they have the right to offer more expensive coverage, and pay the excise tax, most have opted to change. Mine did. So even employer plans are changing.
But what did we expect? Especially, what did conservatives expect? The ACA is largely conservative policy. By forcing most folks to pay for insurance (or be taxed) it enforces personal responsibility. The law also reduces the tax subsidy for employer paid health insurance – it does so indirectly, and in a curious manner, but the net result is to move in the direction long desired by at least one prominent conservative think tank.
But having won on two points, why aren’t conservative happy? (Because they are fucked up?)
If we didn’t make a big change (and Obamacare is a big change) the status quo would be a steady decline with the same bad fact patterns.
So it’s done. It’s needed. Let’s make it work better.
*PS re the use of "Lied." I used lied as a way to garner attention. A headline should be attractive. So that worked. What I did not count on is how folks mistook a headline for analysis. If you read carefully, you will see that I suggest the the president didn't lie. Of course, in some way all political speech is lying in the sense the all the caveats are thrown out. But that is not at all the same as lying.
The self styled conservatives who commented seemed not to read this at all. Hence the focus on ends justifying the means, and on nazi lies. Again, if you read carefully, you will see instead an argument that the ACA is really conservative policy, and should have been widely accepted. But conservatives were in no mood to give Obama even a single vistory.