I was asked by the New York Times to participate in another of its online “Room for Debate” exchanges. Here’s what I submitted:
The Obama administration and its allies are trying to create the political perception that the mandated coverage provisions that are going into effect this year will take the steam out of the repeal effort. That’s very unlikely to be the case. Yes, some Americans will benefit from these insurance requirements, even as many millions of others pay higher premiums to cover the costs.
But these provisions — both in terms of the benefits provided, and the costs imposed — are relatively minor in the scheme of things. Much more significant provisions will be implemented in 2011 and beyond.
And these changes won’t be all good news for American consumers. There are large tax increases in the new law, benefit cuts for Medicare Advantage enrollees, and costly burdens for employers that will raise premiums for millions of people with job-based coverage. Moreover, many employers will be reconsidering offering coverage at all based on the new law’s option for putting workers into new state-based exchanges. This will be disconcerting to millions of workers who are perfectly happy with the insurance they have today.
Republicans have said they are for “repeal and replace,” not just repeal, which means they could roll back the new health law even as they put in place new provisions to ensure secure insurance for those benefiting from the mandates kicking in this year. For instance, Republicans support robust funding for high-risk pools, which would allow many more people with pre-existing conditions to get insurance than will be helped by the modest pools in the new law.
The provisions that are going into effect this year aren’t central to the law’s significant changes to American health care. Repeal is resonating with a large segment of the population because much more sweeping changes are in the works, changes that will redistribute wealth, disrupt insurance arrangements that most people find perfectly acceptable today, and create risks for the quality of American health care. Those concerns are not going away anytime soon.