On the ACA 4. The bill Landrieu is offering could really harm the law. It would mean millions of people who wouldve left the individual insurance market and gone to the exchanges will stay right where they are. Assuming those people skew younger, healthier, and richer -- and they do -- The Affordable Care Acts premiums will rise. Meanwhile, many people who couldve gotten better insurance on the exchanges will stay in bad plans that will leave them bankrupt when they get sick. I think it would be a real substantive mistake to do the Landrieu bill, says MIT health economist Jon Gruber, a supporter of the Affordable Care Act. 5. Put simply, the Landrieu bill solves one of The Affordable Care Acts political problems at the cost of worsening its most serious policy problem: Adverse selection. Right now, the difficulty of signing up is deterring all but the most grimly determined enrollees. The most determined enrollees are, by and large, sicker and older. So the Web sites problems are leading to a sicker, older risk pool. Landrieus bill will lead to a sicker, older risk pool. The Affordable Care Act has provisions meant to stop an out-of-control death spiral, but higher premiums are a real danger. [...] Its useful to think of this in terms of who, on the margin, should be paying higher premiums: The people whove benefited from the various kinds of discrimination that undergird the current system, or the people whove been victimized by that discrimination? Bills like Landrieus lower premiums for people who have benefited from the system at the cost of raising them for the people whove been locked out of the current system. [...] 12. Ultimately, the White House needs to be able to convince congressional Democrats that their best chance in 2014 is a working law. Solving a political problem now at the case of worsening a policy problem 10 months from now isnt a good trade. But they cant do that unless congressional Democrats are confident that the White House can make the law work.-Ezra Klein
Posted on: Mon, 03 Mar 2014 00:36:31 +0000