BuzzFeed Ben Smith published a much-discussed piece today with a story on health care that falls right in Ben's wheelhouse. The provocative headline is intended to drive clicks: "Obama Prepares To Screw His Base."
Well, the president must have done something pretty shocking to generate a headline like that one, right? Maybe there's some massive giveaway planned for the State of the Union? Perhaps the White House intends to trade away some important progressive priority? No, in this case, Ben Smith thinks President Obama is "screwing" his base through the Affordable Care Act.
President Obama's enemies often accuse him, in the starkest political terms, of crudely acting to shift resources toward his political base: green-energy donors, single women, Latinos, African-Americans.But the next 12 months are likely to reveal the opposite. Imminent elements of Obama's grandest policy move, the health-care overhaul known as ObamaCare, are calculated to screw his most passionate supporters and to transfer wealth to his worst enemies.
It's well documented that Obama has thrived politically thanks to the support of younger voters, but as Smith sees it, the administration's signature domestic policy punishes those same voters due to a nefarious scourge known as ... actuarial science.
Just at the surface, the BuzzFeed charge may itself seem strange. After all, the Affordable Care Act allows young adults to stay on their family health care plans through until 26 -- one of Obamacare's most popular features. Indeed, the only segment of the adult population in which the rate of uninsured is falling is 18 to 25 year olds. It's the same law that covers preventive care -- including contraception -- without a copay, which appears to be of some interest to young adults.
If the president intends to "screw" this part of his base, he has a funny way of showing it.
But just below the surface, Smith's charge is not without a substantive policy foundation. Indeed, it's one that's been explored at length, many, many times, over the last several years.
The biggest beneficiaries of the Affordable Care Act -- which is to say, those who'll get the biggest bang for their health care buck -- are those who are most likely to need medical care that they might otherwise be unable to afford. But the further we get from the needlessly inflammatory, please-Drudge-link-to-me BuzzFeed headline, the less outrageous the Obamacare policy is.
It's pretty straightforward when you think about it: on average, as people age, they're not as healthy. It's just an unpleasant fact of life: the older we get, the better the chances we'll need a doctor.
For Ben Smith, that means young people are getting screwed by the president they helped elect: that rascal in the White House is forcing those young people -- the folks Obama brought health care coverage to -- to pay into a system that they probably won't need as much as their older counterparts.
For those who understand the passage of time, and the fact that those young people will get older and begin to need more medical attention, the notion that the president is "screwing" them over is a little silly.
I'll gladly concede that, before the Affordable Care Act, younger, healthier people could get away with cheaper insurance because insurers assumed, correctly, that they're likely to need less coverage. Under Obamacare, they'll pay a little more, but get better insurance and have the assurance that the protections will continue as they get older.
Indeed, all social-insurance programs work this way. By Ben Smith's logic, young people who celebrate Medicare and Social Security are "screwing" themselves by paying into a system that they probably won't produce any benefits for them from for many decades. And yet, those same Obama-voting young people tend to support Medicare and Social Security as pillars of modern American life, which must be protected against Republican privatization efforts.
Either they're fools, blind to their own priorities and interests, or -- I hope you're sitting down -- young adults are capable of thinking about short- and long-term considerations when evaluating parties, candidates, and policy agendas.
Jeffrey Young had a good piece on the larger policy.
What may seem like a contradiction or an unintended consequence of the massive health care overhaul is in fact one of its chief aims: Mandating a minimum set of benefits that go beyond what skimpy plans sold to younger and healthier people now offer. Those current plans don't always cover needed medical services and can leave customers exposed to high health care costs or even financial ruin.The law also seeks to guarantee coverage at lower prices to people as they get older and sicker, but in exchange, it is possible they will pay more into the system when they are young and healthy and need less medical care. Tax credits will be available to many poor and middle class people to subsidize their insurance costs.
Linda Blumberg, a senior fellow at the Urban Institute, told the Huffington Post, "When you are adding some benefits to what people have today and you're adding value to the insurance they're buying then, yes, we're talking about premiums going up. Whether or not that's a positive or a negative for them, I think, depends a lot on perspective."
Quite right. And if you're Dorian Gray, you may have the perspective of someone annoyed by how social-insurance programs work. If you age, however, you are not getting "screwed" by the Affordable Care Act.