There Are No Easy Fixes

Barro analyzes the Obamacare bills moving through Congress:

[Sen. Mary Landrieu’s] bill would obligate insurers to continue offering all the plans they offer today unless they entirely exit the health insurance business in a state. What will Republicans do with this proposal? Do they really want a federal law that says health insurers can’t enter or exit specific lines of business?

Rep. Fred Upton (R-Mich.) has introduced a bill in the House that would allow insurers to continue offering plans that would have been prohibited under the Affordable Care Act, but his bill is vulnerable to the criticism that it will still lead to a raft of plan cancellations as insurers choose to discontinue plans because the ACA has changed the financial incentives they face.

If Congress really wants to make sure people can take their plans, it will need to use the heavy-handed Landrieu approach; the light-touch Upton approach won’t work.

Ezra Klein is against Landrieu’s bill:

The bill Landrieu is offering could really harm the law. It would mean millions of people who would’ve left the individual insurance market and gone to the exchanges will stay right where they are. Assuming those people skew younger, healthier, and richer — and they do — Obamacare’s premiums will rise. Meanwhile, many people who could’ve gotten better insurance on the exchanges will stay in bad plans that will leave them bankrupt when they get sick.

Erick Erickson sees the Landrieu bill as a trap for Republicans:

Here’s what is going to happen.

The House, with the help of a good number of Democrats, will pass the Upton plan and send it to the Senate. Harry Reid will substitute the Landrieu plan and send it back to the House. The House will be forced to either vote for the Landrieu plan or be characterized as siding with insurance companies against people.

In one fell swoop, the Democrats will have the GOP on record saving Mary Landrieu’s re-election in Louisiana by casting her as the one who saved Americans’ health care plans, and also getting on record as really being in favor of fixing Obamacare with the use of mandates.

Sargent checks in on House Democrats:

A senior Democratic aide tells me opposition to the Upton plan will be increasingly difficult to maintain among House Dems if the administration doesn’t offer a workable fix of its own. The aide adds the need to maintain House Dem opposition has been made more urgent by another problem: Senate Dems (the latest being Dianne Feinstein) supporting their own politically expedient “fixes” that could also undermine the law.

Though he thinks it’s bad policy, Jon Walker doubts the Upton bill would do much damage to Obamacare:

[I]nsurance companies have spent months preparing for the switch over to the exchanges. They have already cancelled many of these plans and tried to move people to new ones. Trying to undo that in only a few weeks it a lot of work for just another year. There is a good chance many insurance companies will simply choose not to offer these plans any more.

This law would probably result in a few hundred thousand healthier and wealthier people not joining the exchanges next year. While that would impact the actuarial models the insurance companies were using to set premiums on the exchanges, I think the impact would be modest and not of great concern. I feel the danger is being greatly overstated.

But Sarah Lueck foresees major problems with the bill:

While the Upton bill would extend the availability of non-ACA-compliant plans only through 2014, there would be pressure next summer and fall to extend their availability through 2015 or (more likely) permanently.  That would permanently raise premiums in marketplace plans, further discouraging healthy people from enrolling and threatening the marketplaces’ long-term viability and, hence, the extension of coverage to millions of uninsured near-poor and middle-income Americans.