The title is borrowed from a post by Salon’s Brian Beutler that addresses what he calls the moral conundrum facing right-wing extremists when the Obamacare website starts working. Buetler, who in a previous post reveals he is not only an Obamacare supporter but a user, appears to be painting himself into a corner by speaking of when, rather than if, the site works, but he believes his smugness is justified by “the confluence of two pieces of news last week”:
The first came from Jeffrey Zients — the Obama administration point person in charge of fixing Healthcare.gov — who told reporters on Friday that the site will be able to handle 50,000 users at a time and 800,000 users a day by the the [sic] end of next week. That’s double the current capacity, and right in time for an expected surge in demand just before the end of the year.
The second came from the pro-reform group Families USA, which examined options available to 15 million people who are currently covered on the individual market (many of whose policies have been canceled and will lapse by the end of the year) under the Affordable Care Act.
According to Families USA, over 70 percent of those currently insured will either qualify for premium tax credits on state-based insurance exchanges, or become newly eligible for Medicaid coverage under the healthcare law.
The accuracy of these claims — one comes effectively from the White House itself, which has a vested interest in putting a happy face on its website repair efforts, the other from a “pro-reform group,” which is thus partisan — is at least questionable. But even if they weren’t, they fail to justify Buetler’s conclusion that a successful Obamacare creates a moral dilemma for conservatives. Who, regardless of political ideology, wouldn’t welcome a better and cheaper health care delivery system regardless of its provenance?
The problem for Buetler and others on the hard left is that Obamacare is not that alternative. The claims of unaffordability are so ubiquitous and well-documented that they almost go without saying. Here nevertheless are examples from the non-partisan Congressional Budget Office:
- A projected 7 million fewer people will have employment-based health insurance thanks to Obamacare.
- About 10 to 15 million people who would have bought insurance in the nongroup market without the ACA will face higher premiums before subsidies, on average, primarily because insurance policies will be required to cover a much larger share of health care costs.
- In 2023, under Obamacare, the federal government will pay a budget-crippling $1.615 trillion for health-care expenses, including $903 billion on Medicare, $578 billion on Medicaid and the Children’s Health Insurance Program (CHIPS), and $134 billion on Obamacare premium subsidies and related expenses.
The moral dilemma, then, is one facing Democrats. Even if, as in Beutler’s wildest dream, the administration can point to “a working site that can service nearly a million people a day,” what good is that site if it gets no visitors — or worse still the wrong visitors (i.e., the elderly and/or infirm)?
The Associated Press reports that in several states with working insurance exchanges, the Millennials the administration needs to reel in to make Obamacare financially viable are not biting.
Insurers have warned that they need a wide range of people signing up for coverage because premiums paid by adults in the younger and healthier group, between 18 and 35, are needed to offset the cost of carrying older and sicker customers who typically generate far more in medical bills than they contribute in premiums.
[But] in California, the state with the largest uninsured population, most of those who applied were older people with health problems. In Kentucky, nearly 3 of 4 enrollees were over 35. In Washington state, about 23 percent of enrollees were between 18 and 34. And in Ohio, groups helping with enrollment described many of those coming to them as older residents who lost their jobs and health coverage during the recession.
Nicole Kasabian Evans of the California Association of Health Plans told AP that in general, someone in his 60s uses $6 in health care services for every $1 tallied by someone in his 20s. That makes younger adults a coveted group on industry balance sheets.
So what happens if you create a government health care website and nobody shows up?
It seems Brian Beutler needs to think outside the box a bit more and consider where and his fellow libs will be if the site does work, only to confirm the growing sense that the law is the clunker conservative saw it for right away.
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