Bill Clinton Is Wrong. This Is How Obamacare Works. By Jonathan Cohn. The New Republic, November 12, 2013.
ObamaCare and the End of Civilization. By Jonathan S. Tobin. Commentary, November 13, 2013.
Regime Sells Obamacare to Millennials with Promise of Sex Without Consequences. By Rush Limbaugh. RushLimbaugh.com, November 13, 2013.
Bill Clinton: Obama Should Honor His Keep Your Plan Promise. Video. GOPICYMI, November 12, 2013. YouTube.
Bill Clinton is making waves with his comments that President Obama should honor his “like it, keep it” promise, even if it means changing the Affordable Care Act. Clinton isn’t only the one saying this: Democrats nervous about the future of the law have been increasingly taking this line over the last week. But Clinton is the most prominent person, besides, arguably, Obama himself, to say it, and Jonathan Cohn has a thoughtful piece at the New Republic about the problem with this position. In brief, Cohn argues that you can’t actually reverse the insurance cancellations without also crippling the law itself. There’s no world in which the ACA could do what it has set out to do—expand access to relatively comprehensive insurance—without disrupting plans people already have.
Is that a worthwhile tradeoff for reform? Obviously that’s a matter of opinion. The fact that some people—even a small, relatively affluent group—are giving up something they had makes their plight more sympathetic. They are right to say Obama could have made clear his promise might not apply to them. And there’s a principled argument about whether people should be responsible for services they’re unlikely to use presently, whether it’s fifty-something year olds paying for maternity care or twenty-something year olds paying for cardiac stress tests.
But the principle of broad-risk sharing—of the healthy subsidizing the sick, of the young subsidizing the old, and everybody paying for services like pediatrics and maternity care—is one built into the insurance most Americans already have.
Read the whole thing; Cohn is right that Clinton and Obama can’t eliminate the disruption to pre-existing plans without also rolling back the other beneficial effects of the law. That doesn’t mean there isn’t a better way to balance the tradeoffs here, as a truly consumer-directed health care reform would do, but it does mean that as long as the ACA is law, Clinton is asking the near impossible.