A NYT article from 12/9 explains how Marco Rubio has quietly undermined the ACA and is responsible for higher health care premiums, for plan cancellations, and for some insurers to close their doors. Yet, he continues to be praised by the very same people he's giving the shaft. Why? In my opinion, the lack of basic economic literacy.
Insurance companies adjust rates based on the pool of people they insure. If that pool is expected to use more health care, premiums rise. In the first few years of the ACA, without strong incentives for the healthy and financially capable to sign up (because the opposition watered down the penalties), only those uninsured and in poor health sign up. The purpose of the "temporary" reimbursements to insurers referenced in the article is to offset these risks and uncertainties through 2016, otherwise insurers would have had no choice but to set very high rates in anticipation of a less healthy- more expensive- pool. If that were to happen, then adverse selection would lead to the end of any effort -the vast majority of Americans supported- to provide uninsured citizens with basic health coverage.
Rubio and his fellow Republicans, betting that they understand basic economics better than their supporters, killed the provision to reimburse insurers for anticipated adverse selection problems. Their actions are nothing more than political sabotage. Killing the provision has ZERO economic merit and does nothing but shift the cost of adverse selection from "taxpayers" to health care consumers - who are the same people! Rubio and his colleagues are willing to throw everyone under the bus, calling it "saving the taxpayer" hoping to fool the uninformed without ever offering any acceptable policy or reform to make it better. Many conservatives reading this article, quick to blame Obama and the ACA for the cancellation of plans, higher out-of-pocket expenses, and insurers going out of business, are playing the fool. Few of Rubio's supporters have any idea how they are being used to only support a political power grab, while still paying for it all in the end (pun intended).
Marco Rubio Quietly Undermines Affordable Care Act
http://nyti.ms/1SNNu0n
OK, I follow your argument. You're upset about being told what to do and you think that if we just leave it all up to benevolent wealthy people to provide public goods through charity when they "please", everything will be better. But we know it will not, too many of the haves will free ride off those they feel are even better off, it's human nature. In the end, we will not be able to provide an adequate level of public goods and services needed by society, and that will have very costly long term effects. We know from economic research and historical trial and error that the best solution is to create some sort of fair social contract. Don't get hung up on government, government is synonymous with social contract. Our mixed private/public system is one form of the contract, socialism and communism are others. We get to choose the contract that we feel is best but no contract will be perfect nor will everyone like it the same. Some will attempt to take advantage of the loopholes in the contract, some will argue they are overly burdened in the contract, that's never going to change. When you change the terms of the contract to help some, it will always cause others to pay more, you hope that on net the changes you made to help outweigh those who lose. The ACA could have been better but those who were going to lose paid their lobbyists more to weaken cost control measures on the health care industry. We caved on making the penalty (read: incentive to encourage the right balance in the social contract) for not getting insurance by those financially capable high enough. Yet despite these shortcomings, which hopefully government can address in future years, the ACA is on net, better social contract language then we had, that is not disputable. If others can come along and suggest better contract language that our best economic estimates say,on net, will be better than what we have now, I'll be there to vote for it even if that means I'm one of the losers, because that's what successful societies and economic systems need to do.