In response to the numerous policy cancellation stories, Chait argues that the individuals experiencing rate shock are getting a good deal, in the long-term:
[I]t is true that some people actually are getting decent individual health insurance, and have to pay more under Obamacare. Before, insurers could charge them a rate based on their individual likelihood of needing medical care, and some people are lucky enough to present a very low actuarial health risk. Now those people will have to pay a rate averaging in the cost of others who are less medically fortunate.
Have those healthy 5 percenters who do have decent insurance “lost” under Obamacare? In the very immediate sense, yes. That is what Obamacare advocate Jon Gruber is getting at when he concedes that 3 percent of Americans will be worse off under the new law. They’ll be paying higher rates in 2014 than they would have.
Yet this takes an oddly narrow view of their self-interest. You may pose a low actuarial risk today, but you cannot be certain your luck will continue for the rest of your life (or until you qualify for Medicare). Even people living the healthiest lifestyles suffer illnesses and accidents, or marry people who have a uterus. Those who are paying a higher rate are getting something for their money: a guarantee that some future misfortune won’t lock them out of the market. You might call such a guarantee “insurance.”
Barro zooms out on the healthcare debate:
[P]oliticians run around talking about how wonderful American health care is. Republicans have a de-facto agenda of opposing any reform to the health insurance system. Democrats are reduced to lying and saying their reform efforts won’t change anything for people who like the coverage they have, because huge numbers of Americans have decided for some insane reason that they like the crazy expensive, often spotty, not-especially-effective coverage they have.
I support Obamacare because I believe it will improve our terrible health care system on the margins. Subsidies will tend to be shifted toward people who need them and away from those who don’t. More people will be covered. Modest cost control improvements will be implemented, such as through a tax on high-cost plans and new payment systems that encourage providers to focus on producing good outcomes rather than providing expensive treatments.
But the real problem with Obamacare is that it does not change the American health care system enough in the direction of other countries’ systems. Republicans are wrong to warn that Obamacare will turn America’s health care system into a European-style one. I wish they were right.
Reader thoughts on Obamacare’s losers here.
The Dish 