Lousy Medicaid arguments

Oct 22 2013, 02:47 IST
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SummaryFirst came the false claims of rate shock, and now we have claims that Medicaid makes you sicker

Paul Krugman

For now, the big news about Obamacare is the débâcle of HealthCare.gov, the web portal through which Americans are supposed to buy insurance on the new health care exchanges. For now, at least, HealthCare.gov isn’t working for many users.

It’s important to realise, however, that this botch has nothing to do with the law’s substance, and will get fixed. After all, a number of states have successfully opened their own exchanges, doing for their residents exactly what the federal system is supposed to do everywhere else. Connecticut’s exchange is working fine, as is Kentucky’s. New York, after some early problems, seems to be getting there. So, a bit more slowly, does California.

In other words, the technical problems, while infuriating—heads should roll—will not, in the end, be the big story. The real threat remains the effort of conservative groups to sabotage reform, especially by blocking the expansion of Medicaid. This effort relies heavily on lobbying, lavishly bankrolled by the usual suspects, including the omnipresent Koch brothers. But it’s not just money: the right has also rolled out some really lousy arguments.

And I don’t just mean lousy as in “bad”; I also mean it in the original sense, “infested with lice.”

Before I get there, a word about something that, as far as we can tell, isn’t happening. Remember “rate shock”? A few months ago it was all the rage in right-wing circles, with supposed experts claiming that Americans were about to face huge premium increases.

It quickly became clear, however, that what these alleged experts were doing was comparing apples and oranges—and as Ezra Klein of The Washington Post pointed out, oranges that, in many cases, you can’t even buy. Specifically, they were comparing the premiums young, healthy men were paying before reform with the premiums everyone—including those who previously couldn’t get insurance because of pre-existing conditions—will pay under the new system. Oh, and they also weren’t taking into account the subsidies many Americans will receive, reducing their costs.

Now people are signing up for policies on state exchanges and, to a limited extent, on the federal exchange. Where are the cries of rate shock? Anecdotal evidence, which is all we have so far, says that people are by and large happily surprised by the low cost of their insurance. It was telling that when Fox News eagerly interviewed some middle-class Americans who said they had been hurt by the Affordable Care Act, it

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