The president repeated incessantly that, under Obamacare, Americans could keep their current coverage:
Rarely has a major domestic program been sold on the basis of a premise so patently untrue. No matter what you’ve heard from the president of the United States, hundreds of thousands of people in states around the country are now receiving notices that their insurance is getting canceled. It raises the question of how the president could be so wrong about a basic element of his own signature initiative.
Greg Mankiw runs through various possibilities. Which is more worrying: that the president only vaguely knew what he was promising or that he consciously lied about it? So, on this issue, he is either a spectator of his own administration or a snake-oil salesman. The truth has always been that the ACA would impose a minimum level of benefits, meaning that many folks with cheap and not-so-great policies in the individual market will have to upgrade. So the ACA punishes a small group of people – those who have been thrifty with health insurance. As Ross points out, this is an odd incentive to impose:
If we want health inflation to stay low and health care costs to be less of an anchor on advancement, we should want more Americans making $50,000 or $60,000 or $70,000 to spend less upfront on health insurance, rather than using regulatory pressure to induce them to spend more. And seen in that light, the potential problem with Obamacare’s regulation-driven “rate shock” isn’t that it doesn’t let everyone keep their pre-existing plans. It’s that it cancels plans, and raises rates, for people who were doing their part to keep all of our costs low.
[White House press secretary Jay] Carney’s reply to this is, essentially, (a) a lot of people will be able to keep their plan if they like it, even if it’s not quite everyone, and (b) those who are getting dropped from their plans will get more comprehensive coverage on the exchanges. The latter point is like having the CEO of DirecTV tell customers that their monthly bill is about to double but they’ll now receive an extra hundred channels in return, maybe one or two of which people will actually watch.
Comprehensive coverage is lovely, but if you’re on a budget basic coverage might be more cost-effective; why pay $1,000 extra a year for a new package that includes substance-abuse treatment, say, if you don’t drink or do drugs? Obama took the option of cheaper catastrophic care away from people because insurers wanted to squeeze healthy middle-class suckers for extra revenue by forcing coverage on them that they don’t need. And yet Carney’s basically selling this as a *good* thing about the law, a sort of upgrade over the basic — but affordable! — plans people have now. Remind me again: Isn’t “affordability” supposed to be a key plank of the Affordable Care Act?
Frakt refuses to defend Obama’s promises about keeping coverage:
Let’s start with “if you like your plan you can keep it.” This is never, uniformly true. Plans change every year, even in the years before Obamacare was conceived. The truth is, if you like your plan, there’s a good chance it will change. That’s just as true, if not more so, under Obamacare. I do not endorse or defend this statement.
What Obama might have more plausibly have said is that Obamacare makes only minor or modest changes to coverage for the vast majority of Americans. Where it makes the biggest change is for the minority of Americans who cannot obtain affordable coverage today. That I could defend, though I am sure others would still contest it.
When it was originally contemplated, several years away from implementation, the process of imposing regulations on the individual-health-insurance market did not feel like taking people’s health insurance away from them. In the current moment, with cancellation notices going out and alternatives not yet available, it feels exactly like that. Which is to say, a promise that felt like a mere oversimplification at the time, and may eventually feel like one in retrospect, currently feels like a lie.