Mark Argosh details ♡bamaCare!!!’s winners and losers in today’s New York Daily News — hardly a rightwing paper. The winners are old people and Americans on Medicaid. The losers are pretty much everyone else:
The poor : The poor face two major issues: the lack of Medicaid expansion in many states and the lack of government assistance. Without expanding Medicaid, many families below the poverty level are in an orphan status: neither eligible for premium subsidies nor for Medicaid. Due to a design flaw in the employer mandate, many families of the working poor will also be ineligible for government assistance because employers are not required to contribute to family members’ plans.
Small and mid-sized businesses : As a result of the current employer mandate, many small businesses have curtailed job expansion to stay below 50 employees or are cutting benefits for existing employees to cover added costs.
Millennials : As they are entering the workforce or aging beyond their parent’s insurance, millennials will be forced to pay higher costs for individual health coverage to facilitate the lower costs for older populations.
The Healthy : The Affordable Care Act presents a unique and untapped opportunity to bend the medical cost curve in America. While Obamacare allows health plans to charge higher premiums for tobacco usage, plans should also provide a real pricing incentive for people to engage in healthy behaviors.
Social Security and Medicare “worked” (I used scare quotes because of the programs’ long-term insolvency, especially Medicare) because while everybody paid, everybody benefitted to at least some degree. Under ♡bamaCare!!!, the rich pay quite a bit, but also have the least harm done to their existing plans. The middle class and the young pay through the nose, and for worsening care. That’s Plus there are ♡bamaCare!!!’s lovely external harms, like reduced growth (due to higher taxes on investment) and reduced fulltime employment.
That’s an awful lot of harm just to bring modest benefits under a Byzantine, almost Brazil-like, new bureaucracy to navigate for the recipients of all this largess.
And that will be the law’s undoing.