January 24, 2014
For all its many flaws Obamacare will prove to be a great thing for the simple reason that it will guarantee most of the population affordable health care insurance. The key group here is not the uninsured, many of whom will be able to get insurance as a result of the law, but rather the bulk of the under age 65 population whose insurance depends on their job. For the first time, these people will be in a situation where if they lose their job, they will still be able to get insurance they can afford. (Yes, I know that not everyone will find the insurance available through the exchanges affordable, hence the use of the word “most.”)
Anyhow, it is fascinating to see the continuing vitriole of the right against Obamacare, which is bearing ever less relationship to reality. We have heard endless talk about how Obamacare was creating a “part-time nation” as employers reduced work hours to get under the 30-hour cutoff for employer sanctions under the ACA. This one suffers from the problem that there were fewer people reported as working part-time at the end of 2013 than at the end of 2012. (Some of us are fans of voluntary part-time employment.)
Ed Rogers, writing in the Washington Post, told readers that the number of uninsured was rising because Target had stopped offering insurance to part-time workers. (Apart from the limited impact of the insurance status of Target’s part-time employees on national insurance rates, it is possible that Target stopped offering part-timers the option to buy into their insurance because few were taking it, given the expansion of Medicaid and the subsidies in the exchanges under the ACA.)
Wilson then linked to a “smart piece” by Megan McArdle which touted the imminent demise of Obamacare. Among the troubles of Obamacare cited by McArdle is that many of the people now signing up for Medicaid were already eligible before the ACA. This is an interesting claim, but so what if it is true? They previously had not been covered, now they are. And the problem is?
Another of the highlights is that the $2,500 in savings for a typical family has not materialized. Actually slower growth in health care costs have reduced spending by more than 10 percent compared to what was projected in 2008. That would translate into savings in the ballpark of $2,500 for a family of four. Clearly much of the slower cost growth was not due to the ACA, but does anyone doubt that if cost growth had accelerated it would be blamed on the ACA?
Anyhow, as the exchanges and Medicaid expansion become more a part of the health care framework, the ACA is going to gain increased acceptance even by Republicans, just as Medicare did. At some point, clever Republican politicians will recognize this fact and adjust their message to stay in line with their base. Meanwhile, the dead enders will get ever further removed from reality as they continue to push for the repeal of Obamacare.
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