With the implementation of President Obama’s health care law facing mounting challenges, liberals are laying the groundwork to blame any failures of the law on the opposition of its critics.
Over at the Washington Post, for example, Jonathan Bernstein used my work to argue that opponents are undermining implementation so they can complain Obamacare doesn’t work. Specifically, he cited my feature story on five ways Obamacare could fail and my argument against the NFL forming a marketing partnership to promote the health care law.
In other words, Bernstein’s point is that on one hand, I observed that getting more younger and healthier Americans to sign up for insurance is essential to Obamacare, and yet on the other hand, I attacked efforts to educate them about the law.
“It’s possible that the (Affordable Care Act) will collapse,” Bernstein concludes after highlighting Republican efforts to oppose the law. “But if it does, it’s unlikely it will be the result of inherent problems with the legislation. If Obamacare fails, it’s going to be because the Republican Party’s all-out war on it — a war that doesn’t seem to have any concern at all for health-care consumers or the economy — succeeds.”
Bernstein, I should acknowledge, is an earnest liberal with whom it’s easy to have a civil debate. But this argument strikes me as a desperate attempt to shift blame for any potential problems with Obamacare’s implementation. It’s also a bit odd to argue that once a controversial piece of legislation passes, critics should just abandon their opposition to it.
My basic disagreement with him is that I believe the problems with Obamacare stem from its very design. For instance, the reason why it’s questionable that young people will sign up for insurance is that Obamacare’s design makes insurance much more expensive for younger individuals in the name of making it more accessible for older and sicker Americans.
Under a market-based approach, the government would end the discrimination in the tax code against individuals purchasing insurance on their own. It would also remove regulatory barriers to younger Americans purchasing lower cost insurance with fewer benefits given their lower medical needs, instead of the more comprehensive policies required in many states under current law, and expanded under Obamacare.
Short of that, as I wrote recently, the designers of Obamacare could have done more to consider the elasticity of demand of different age groups when calculating subsidies in the government-run insurance exchanges.
In California, I observed, a 26 year-old earning $32,000 per year would obtain $0 in subsidies toward the purchase of insurance while a 59 year-old with the same income would receive $4,344. As I demonstrated, if some of that money were shifted toward the younger Californian, suddenly health insurance would become a much more attractive investment.
So to reiterate, Obamacare made insurance a bad deal for many young Americans by design. Why should American football fans who oppose Obamacare and just want to be able to watch games free of politics on Sunday be made to suffer for this design flaw? Why should those who oppose the law allow the sports world to be hijacked without raising a fuss?
This is just one example. Both by choice and political necessity, Obamacare ended up with a specific structure. For instance, there’s the issue of Republican governors refusing to create state-based health insurance exchanges.
When the legislation was moving through Congress, Democrats couldn’t get a national exchange through the Senate, so, they tried to design the law in a way to let the states do the heavy lifting. They determined that the federal government would step in to establish an exchange in any state that chose not to participate in the exchanges, thinking that states that wanted more control would choose to go on their own.
But the law included so many restrictions that prevented states from having any real flexibility that 33 states decided to let the federal government run all or part of their exchanges, as consistent with the law. This has made implementation harder for the Obama administration. But how is following the law undermining the law?
During the health care debate, Democrats decided that, since they controlled 60 votes in the Senate, they should pass the most liberal bill that could get that vote total, rather than a much less comprehensive bill that may have enjoyed broader support. They also made the calculation that, once they passed the law and the debate moved away from the ugly legislative process, then the public would come to embrace it.
Instead, the law’s popularity has declined, and it cost Democrats control of the House of Representatives in 2010, while also fueling the Republican takeover of many of the nation’s governorships and state legislatures.
Now, many Republicans are using their elected offices to resist the law, as they were elected to do. So, let us not forget that the reason why Republicans have the power to resist Obamacare is because of Obamacare.