by Max Brantley
Start with the goal that almost everyone at least pretends to support: giving Americans with pre-existing medical conditions access to health insurance. Governments can, if they choose, require that insurance companies issue policies without regard to an individual’s medical history, “community rating,” and some states, including New York, have done just that. But we know what happens next: many healthy people don’t buy insurance, leaving a relatively bad risk pool, leading to high premiums that drive out even more healthy people.
To avoid this downward spiral, you need to induce healthy Americans to buy in; hence, the individual mandate, with a penalty for those who don’t purchase insurance. Finally, since buying insurance could be a hardship for lower-income Americans, you need subsidies to make insurance affordable for all.
Moreover, he predicts it will work — unless sabotaged by the bitter-end political opposition. People who've been uninsured will be covered. Millions more will see a reduction in their costs.
And because so many people will see clear benefits, health reform will prove irreversible.
Yes, but ..... What if the benefits are delayed enough to help power a Republican electoral sweep in 2014? Will Obamacare at the national level — and things like Arkansas's Obamacare implementation on which it depends — be swept away in that tide?
Speaking of Obamacare: A friend sent a link to this article which explains in some specific detail why the Affordable Care Act is good for middle class people, too.