Paul Krugman on succesful implementation of ‘ObamaCare’


Posted by AzBlueMeanie:

Paul Krugman has more on the good news for the implementation of "ObamaCare" today. The
Obamacare Shock

The Affordable Care Act, aka Obamacare, goes fully into effect at the
beginning of next year, and predictions of disaster are being heard far
and wide. There will be an administrative “train wreck,” we’re told;
consumers will face a terrible shock. Republicans, one hears, are
already counting on the law’s troubles to give them a big electoral

[See this AP report GOP to frame 'debacle' of Obama health law as 2014 campaign issue in today's Arizona Daily Star.]

No doubt there will be problems, as there are with any large new
government initiative, and in this case, we have the added complication
that many Republican governors and legislators are doing all they can to
sabotage reform
. Yet important new evidence — especially from
California, the law’s most important test case — suggests that the real
Obamacare shock will be one of unexpected success.

Before I can explain what the news means, I need to make a crucial
point: Obamacare is a deeply conservative reform, not in a political
sense (although it was originally a Republican proposal) but in terms of
leaving most people’s health care unaffected. Americans who receive
health insurance from their employers, Medicare or Medicaid — which is
to say, the vast majority of those who have any kind of health insurance
at all — will see almost no changes when the law goes into effect.

There are, however, millions of Americans who don’t receive insurance
either from their employers or from government programs. They can get
insurance only by buying it on their own, and many of them are
effectively shut out of that market. In some states,
like California, insurers reject applicants with past medical problems.
In others, like New York, insurers can’t reject applicants, and must
offer similar coverage regardless of personal medical history
(“community rating”); unfortunately, this leads to a situation in which
premiums are very high because only those with current health problems
sign up, while healthy people take the risk of going uninsured.

Obamacare closes this gap with a three-part approach. First, community
rating everywhere — no more exclusion based on pre-existing conditions.
Second, the “mandate” — you must buy insurance even if you’re currently
healthy. Third, subsidies to make insurance affordable for those with
lower incomes.

Massachusetts has had essentially this system since 2006; as a result,
nearly all residents have health insurance, and the program remains
very popular. So we know that Obamacare — or, as some of us call it,
ObamaRomneyCare — can work.

Skeptics argued, however, that Massachusetts was special: it had relatively few uninsured residents
even before the reform, and it already had community rating. What would
happen elsewhere? In particular, what would happen in California, where
more than a fifth of the nonelderly population is uninsured, and the
individual insurance market is largely unregulated? Would there be
“sticker shock” as the price of individual policies soared?

Well, the California bids are in — that is, insurers have submitted the prices at which they are willing to offer coverage on the state’s newly created Obamacare exchange. And the prices, it turns out, are surprisingly low.
A handful of healthy people may find themselves paying more for
coverage, but it looks as if Obamacare’s first year in California is
going to be an overwhelmingly positive experience.

* * *

[T]here will probably be a lot of administrative
confusion as the law goes into effect, again especially in states where
Republicans have been doing their best to sabotage the process.

Also, some people are too poor to afford coverage even with the
subsidies. These Americans were supposed to be covered by a federally
financed expansion of Medicaid, but in states where Republicans have blocked Medicaid expansion, such unfortunates will be left out in the cold.

Still, here’s what it seems is about to happen: millions of Americans
will suddenly gain health coverage, and millions more will feel much
more secure knowing that such coverage is available if they lose their
jobs or suffer other misfortunes. Only a relative handful of people will
be hurt at all. And as contrasts emerge between the experience of
states like California that are making the most of the new policy and
that of states like Texas whose politicians are doing their best to
undermine it, the sheer meanspiritedness of the Obamacare opponents will
become ever more obvious

So yes, it does look as if there’s an Obamacare shock coming: the shock
of learning that a public program designed to help a lot of people can,
strange to say, end up helping a lot of people — especially when
government officials actually try to make it work

Good faith implementation of "ObamaCare" reforms are critical. Contact your state legislators in support of Governor Brewer's Medicaid (AHCCCS) restoration plan. It's time to end the ideological obstruction and sabotage.