The debate is over. The social science is settled. Obamacare has not only won at the Supreme Court, but it has won over the hearts and minds of compassionate, thinking Americans everywhere. Resistance is futile.
Psst. What about those premium increases of 25 percent, 31 percent, even 54 percent that some of the biggest insurers have requested for 2016?
Well, President Obama himself has reassured us that if you like your health insurance premium, you can keep your health insurance premium: "my expectation," he said, "is that they'll come in significantly lower than what's being requested."
Psst. In Oregon, where the regulator has already approved rates for 2016, the regulator actually insisted that some insurers "raise rates in 2016 even more than they had proposed" -- by 35 percent instead of 9 percent in one case, by 20 percent instead of 5 percent in another.
Well, this is surely a temporary hitch in our collective step toward greater coverage for all. As more Americans sign up, we will most assuredly bend the cost curve down.
Psst. The rationale insurers are citing for the premium increases is that the people signing up are older and sicker than expected . The young and healthy are staying away in greater numbers than projected. If the higher premiums keep the young and healthy away, premiums will go up more, the enrolled population will be even more skewed toward older and sicker folks, premiums will go up more and ... well, ever heard of the death spiral?
Death panels! Are you regurgitating that Sarah Palin nonsense?
I said death spiral, not death panels. No one's getting killed, except the attractiveness of Obamacare plans to the people who need to buy them if the plans are to remain viable.
Well, it goes without saying there will be a cost involved if we're going to expand quality health care to more Americans.
Psst. We're not doing that. The physician networks on Obamacare plans are much more limited than what people in employer-sponsored insurance have access to: On average, their networks have 42 percent fewer oncology and cardiology specialists, 32 percent fewer mental health and primary care providers, and 24 percent fewer hospitals . Their choices are much more limited than what most people want. And while some plans allow out-of-network visits, others are even cutting out that option . Instead of giving them something like the employer-sponsored health insurance that most people like, we've given them a glorified version of Medicaid.
Yes, well, we have to make some trade-offs if we are going to run a fiscally responsible program.
Psst. You mean the kind of fiscally sound program that "does not appear to be set up detect fraud," as government investigators found? Those investigators were able to get, and keep, insurance for all 11 fake people they tried to enroll. And when six of them eventually lost their coverage, the investigators were able to talk their way into getting five of them back onto the rolls -- with even larger subsidies than they were getting before, to boot.
Well, at least people are getting help with buying their health insurance. It gives them more financial security.
Psst. The kind of financial security that leaves them with a shock at tax time ? H&R Block reports two-thirds of its customers who bought insurance on an Obamacare exchange and received subsidies in 2014 had to pay back at least part of those subsidies when they filed their taxes this year -- a $729 hit on average.
Well, apart from the rising premiums, worrisome enrollment population mix, shrinking provider networks, vulnerability to fraud, and unexpected tax penalties, what could possibly be wrong with Obamacare?
OK, OK. You got me there.